老年脑卒中患者营养风险评估及与其预后的相关性  

Nutritional risk assessment and its correlation with prognosis in elderly stroke patients

作　　者：蔡 刘琼[1] Cai Ying;Liu Qiong(Department of Neurology,Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院神经内科,上海200025

出　　处：《中华老年多器官疾病杂志》2023年第11期821-825,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：国家自然科学基金(82171241)。

摘　　要：目的分析老年脑卒中患者营养风险及与其预后的相关性。方法选择2020年3月至2022年12月上海交通大学医学院附属瑞金医院收治的老年脑卒中患者88例作为研究对象,采集患者的基础资料、营养水平、神经功能缺损水平、病情预后等信息。对比老年脑卒中患者入院即刻、入院后第7天、出院当天营养相关指标的变化。对单因素分析存在有统计学意义的因素实施多元logistic回归分析。采用SPSS 22.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、Fisher精确检验及χ^(2)检验。结果入院即刻营养不良14例(15.9%),入院后第7天营养不良35例(39.8%),出院当天营养不良33例(37.5%)。入院后第7天、出院当天的血清白蛋白<35 g/L所占比例均较入院即刻高,差异有统计学意义(P<0.05)。通过多元logistic回归分析得知,入院即刻营养不良是入院后第7天发生营养不良的独立性风险预测因子(OR=0.57,95%CI 1.49~13.71;P<0.05);入院即刻(OR=1.05,95%CI 1.02~1.08)及入院7 d后美国国立卫生院卒中量表(NIHSS)评分(OR=6.54,95%CI 1.16~36.87)是不良事件发生的独立性风险预测因子(均P<0.05);入院7 d后营养不良(OR=1.76,95%CI 1.14~2.72)、入院即刻(OR=2.08,95%CI 1.30~3.33)及入院7d后NIHSS评分(OR=4.28,95%CI 1.12~16.36)是病情预后转归不佳的独立性风险预测因子(均P<0.05)。结论对于老年脑卒中患者,要重视其营养风险因素评估,及时关注营养风险因素与个体病情预后的关联性。Objective To analyze the correlation between nutritional risk and prognosis in the elderly stroke patients.Methods A total of 88 elderly stroke patients admitted to Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from March 2020 to December 2022 were selected as the study objects.Their baseline data,nutritional level,neurological impairment level,prog-nosis and other information were collected.A comparison was made of nutrition-related indexes in elderly stroke patients between on admission,on day 7 after admission and on the day of discharge.A multivariate logistic regression analysis was performed for the factors with statistical significance in the univariate analysis.SPSS 22.0 was used for statistical analysis.Data comparison between two groups was performed using t test,Fisher exact test orχ^(2) test,depending on the data type.Results Malnutrition was recorded in 14(15.9%)cases on admission,35(39.8%)on day 7 after admission,and 33(37.5%)on the day of discharge.The proportion of serum albumin<35 g/L on the 7th day after admission and on the day of discharge was higher than that on admission,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that malnutrition on admission was an independent risk predictor of malnutrition on day 7 after admission(OR=0.57,95%CI 1.49-13.71;P<0.05),that National Institutes of Health Stroke Scale(NIHSS)scores on admission(OR=1.05,95%CI 1.02-1.08)and on day 7 after admission(OR=6.54,95%CI 1.16-36.87)were independent risk predictors of adverse events(both P<0.05),and that malnutrition on day 7 after admission(OR=1.76,95%CI 1.14-2.72)and NIHSS score on admission(OR=2.08,95%CI 1.30-3.33)and day 7 after admission(OR=4.28,95%CI 1.12-16.36)were independent risk predictors of poor prognosis(all P<0.05).Conclusion Due emphasis should be laid on the assessment of nutritional risk factors in the elderly stroke patients,and timely attention should be paid to the correlation between nutritional risk factors an

关 键 词：脑卒中 老年人 营养风险 预后 

分 类 号：R543[医药卫生—心血管疾病]