心血管内科老年住院患者营养状态与衰弱情况的相关性分析  

A study on the correlation between nutritional status and frailty among elderly inpatients from cardiology department

作　　者：王丽娟[1] 丁丽丽[1] 陈丽如[1] 程博[1] 朱明炜[1] 王华[2] Wang Lijuan;Ding Lili;Chen Liru;Cheng Bo;Zhu Mingwei;Wang Hua(Department of Clinical Nutrition,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,P.R.China,Beijing 100730,China;Department of Cardiology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,P.R.China,Beijing 100730,China)

机构地区：[1]北京医院临床营养科国家老年医学中心中国医学科学院老年医学研究院,100730 [2]北京医院心内科国家老年医学中心中国医学科学院老年医学研究院,100730

出　　处：《中华临床营养杂志》2022年第3期147-151,共5页Chinese Journal of Clinical Nutrition

基　　金：北京市科委基金面上项目(D181100000218003);中国医学科学院医学与健康科技创新工程项目(2021-I2M-C&T-B-094)。

摘　　要：目的分析心血管内科老年住院患者营养状态与衰弱情况的关系。方法入选2018年9月至2019年2月在北京医院心内科因心血管疾病住院治疗的≥65岁的老年患者。营养状态的评估采用微型营养评定简表(mini nutritional assessment short form,MNA-SF),衰弱情况的评估采用Fried衰弱表型。分析横断面研究的不同疾病、年龄、体重指数(body mass index,BMI)分层患者的营养状态及衰弱情况,以及不同衰弱情况患者的营养状态。结果符合入选标准的519例老年患者进入本研究,平均年龄75.12(65~92)岁。营养不良风险的发生率28.9%(150/519),营养不良的发生率3.3%(17/519),衰弱的发生率为23.5%(122/519)。按疾病分层,慢性心功能不全组的营养不良风险及衰弱比例最高,分别为63.6%和50.0%。按年龄分层(65~75岁、≥75岁),营养不良风险(22.8%、35.5%)、营养不良(3.0%、3.6%)和衰弱(15.3%、32.3%)的发生率均随年龄增长而升高;MNA-SF量表得分与年龄呈负相关(r=-0.134,P=0.002);Fried衰弱表型得分与年龄呈正相关(r=0.319,P<0.01)。BMI以超重和肥胖(≥24)为主,占62.6%,其营养不良风险发生率为21.2%(69/325),而BMI正常的人群营养不良风险的发生率为38.7%(70/181),BMI消瘦组100%处于营养不良风险或营养不良状态;MNA-SF量表得分与BMI呈正相关(r=0.353,P<0.01)。BMI不同组别间衰弱前期和衰弱的发生率差异无统计学意义。衰弱组营养不良发生的比例最高,为8.2%,其次为衰弱前期组2.0%;Fried衰弱表型得分与MNA-SF量表得分呈负相关(r=-0.291,P<0.01)。Logistic回归分析显示,衰弱是营养不良的独立危险因素,衰弱患者营养不良的发生风险是非衰弱患者的4.818倍(95%CI:1.701~13.644)。结论心血管内科老年住院患者营养不良风险以及衰弱的发生率都比较高,衰弱患者更容易出现营养不良,需关注此类人群。Objective To analyze the relationship between nutritional status and frailty among elderly inpatients from cardiology department.Methods A cross-sectional study was conducted in a total of 519 patients aged 65-92 years old who were admitted to cardiology department between September 2018 and February 2019.Mini nutritional assessment short form(MNA-SF)was used to assess the nutritional status.Fried phenotype was used to assess frailty status.The nutritional status and frailty in patients with different diseases,age and body mass index were analyzed,as well as the nutritional status of patients in different frailty strata.Results The mean age was 75.12 years(range:65-92 years).The prevalence of malnutrition risk was 28.9%(150/519),malnutrition 3.3%(17/519)and frailty 23.5%(122/519).When stratified by disease,the subgroup with chronic heart failure showed the highest prevalence of malnutrition and frailty(63.6%and 50.0%,respectively).The prevalence of malnutrition risk(22.8%,35.5%),malnutrition(3.0%,3.6%)and frailty(15.3%,32.3%)were higher in patients≥75 years compared with those aged 65 years-75 years.MNA-SF score was negatively correlated with age(r=-0.134,P=0.002).Fried phenotype score was positively correlated with age(r=0.319,P<0.01).As for stratification based on BMI,the majority(62.6%)patients were overweight or obese(BMI≥24.0 kg/m2)and the prevalence of malnutrition risk in this subgroup was 21.2%(69/325).The prevalence of malnutrition risk in patients with normal BMI was 38.7%(70/181).The subgroup with BMI<18.5 were either at malnutrition risk or with malnutrition.MNA-SF score was positively correlated with BMI(r=0.353,P<0.01).There was no significant difference in the prevalence of pre-frailty and frailty among different BMI groups.The prevalence of malnutrition was the highest in the frailty group(8.2%),followed by the pre-frailty group(2.0%).Fried phenotype score was negatively correlated with MNA-SF score(r=-0.291,P<0.01).Logistic regression analysis showed that frailty was an independent risk facto

关 键 词：心血管疾病 老年 住院患者 营养不良风险 营养不良 衰弱 

分 类 号：R54[医药卫生—心血管疾病] R459.3[医药卫生—内科学]