人体组分在系统性红斑狼疮患者营养评定中的应用  

Application of body composition assessment in diagnosing malnutrition among systemic lupus erythematosus

作　　者：吴晨敏 严青[1] 魏骐骄 高飞[1] 吕心阳 WU Chenmin;YAN Qing;WEI Qijiao;GAO Fei;LYU Xinyang(Department of Rheumatology and Immunology,Shengli Clinical Medical College of Fujian Medical University,Fuzhou Fujian 350001,China;Department of Clinical Nutrition,Shengli Clinical Medical College of Fujian Medical University,Fuzhou Fujian 350001,China)

机构地区：[1]福建医科大学省立临床医学院风湿免疫科,福建福州350001 [2]福建医科大学省立临床医学院临床营养科,福建福州350001

出　　处：《江苏大学学报（医学版）》2022年第5期427-432,共6页Journal of Jiangsu University：Medicine Edition

基　　金：福建省自然科学基金面上项目(2019J0105)。

摘　　要：目的:评估系统性红斑狼疮(SLE)患者的营养状况,分析SLE患者营养不良的危险因素。方法:选取本院风湿免疫科收治的120例SLE患者,根据全球领导人营养不良倡议(GLIM)对SLE患者进行营养评定,分为非营养不良组(n=63)和营养不良组(n=57),对比分析两组患者的临床资料、实验室指标、人体组分数据和SLEDAI-2000评分,Logistic回归分析预测SLE患者营养不良的危险因素。结果:①SLE营养不良组患者的身高、体重、血红蛋白、血白蛋白、补体C3、补体C4水平均明显低于非营养不良组,差异具有统计学意义(P<0.05);SLE营养不良组的SLEDAI-2000评分中位数为6.5,明显高于非营养不良组(1.0,P<0.001)。②SLE营养不良组的全身相位角、身体总水分、蛋白质量、骨骼肌量、身体细胞量、细胞内水分等人体成分明显低于非营养不良组(P<0.05)。③Logistic回归结果显示,全身相位角(OR:0.364,95%CI:0.180~0.737,P=0.005),蛋白质量(OR:0.195,95%CI:0.042~0.892,P=0.035)是SLE患者营养不良的独立影响因素。结论:运用人体组分对SLE患者进行营养评定,可全面、准确地了解患者营养状况,为整体改善SLE患者临床预后提供依据。Objective:To evaluate the nutritional status of patients with systemic lupus erythematosus(SLE)by body composition assessment and to analyze the risk factors of malnutrition in SLE patients.Methods:A total of 120 patients with SLE were selected.According to the global leadership initiative on malnutrition(GLIM),the SLE patients were divided into non-dystrophic group(n=63)and dystrophic group(n=57).The clinical data,laboratory indicators,body composition data,and disease activity(SLEDAI-2000 score)among the groups were compared and risk factors of malnutrition in SLE patients were analyzed by Logistic regression analysis.Results:①The levels of height,body weight,hemoglobin,serum albumin,complement C3,and complement C4 in the SLE dystrophic group were statistically lower than those in the non-dystrophic group(P<0.05).The median of the SLEDAI-2000 score of the SLE dystrophic group was 6.5,which was significantly higher than that of the non-dystrophic group(1.0,P<0.001).②The whole-body phase angle,total body water,protein,skeletal muscle,body cell volume,intracellular fluid of the SLE dystrophic group were significantly lower than those in the non-dystrophic group(P<0.05).③The Logistic regression analysis showed whole body phase angle(OR=0.364,95%CI:0.180-0.737,P=0.005),protein(OR=0.195,95%CI:0.042-0.892,P=0.035)were independent influencing factors of malnutrition in SLE patients.Conclusion:Using body composition assessment to evaluate the nutritional status of SLE patients can comprehensively understand the nutritional status of patients,which has certain clinical significance for multidisciplinary management of SLE.

关 键 词：系统性红斑狼疮 全球领导人营养不良倡议 人体组分 营养不良 营养风险 

分 类 号：R593.241[医药卫生—内科学]