溃疡性结肠炎病人生物电阻抗相位角与营养状况的关系研究  

Association between bioelectrical impedance phase angle and nutritional status in patients with ulcerative colitis

作　　者：刘仁娟 田字彬[1] 王丹丹[2] 刘思凡 刘爱玲[1] 荆雪[1] 丁雪丽[1] LIU Ren-juan;TIAN Zi-bin;WANG Dan-dan;LIU Si-fan;LIU Ai-ling;JING Xue;DING Xue-li(Department of Gastroenterology,the Affiliated Hospital of Qingdao University,Qingdao 266003,Shandong,China;Department of Nutrition,the Affiliated Hospital of Qingdao University,Qingdao 266003,Shandong,China;Department of Gastroenterology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]青岛大学附属医院消化内科,山东青岛266003 [2]青岛大学附属医院营养科,山东青岛266003 [3]首都医科大学附属北京友谊医院消化内科,北京100050

出　　处：《肠外与肠内营养》2023年第6期328-333,共6页Parenteral & Enteral Nutrition

基　　金：2021年度青岛大学附属医院临床医学+X科研项目(QDFY+X202101036);2021年度青岛市医药卫生科研计划项目(2021-WJZD166);山东省自然科学基金资助青年项目(ZR2020QH031)。

摘　　要：目的:探讨生物电阻抗相位角(PA)在溃疡性结肠炎(UC)病人营养评估中的应用价值。方法:回顾性纳入青岛大学附属医院2019年9月至2023年3月的115例住院UC病人,收集其临床资料和营养指标(体格测量、实验室检查及人体成分),测量PA值。根据全球营养领导层倡议的营养不良(GLIM)标准诊断营养不良。根据PA水平将UC病人分为正常PA组和低PA组,比较两组间病人临床特征、营养指标的差异,分析PA与营养指标的相关性,进一步研究UC病人发生营养不良的危险因素。结果:低PA组40例(34.78%),正常PA组75例(65.22%)。绘制受试者工作特征曲线显示预测营养不良的PA女性最佳截断值为4.57°,灵敏度和特异性为0.778和0.905,男性最佳截断值为5.48°,敏感度和特异性为0.784和0.812。与正常PA组比较,低PA组的营养不良病人比例更高(P<0.001),身体质量指数(BMI)、白蛋白(Alb)、前白蛋白、血红蛋白(Hb)水平更低(P<0.05);人体成分中的骨骼肌、身体细胞量(BCM)、骨矿物质含量(BMC)、腰围、四肢骨骼肌指数(SMI)、去脂体质量(FFM)均有不同程度的降低(P<0.05),浮肿指数更高(P<0.001),重度疾病活动比例及改良Mayo评分更高(P<0.01),C-反应蛋白(CRP)、血沉(ESR)水平更高(P<0.05);住院费用更高(P<0.001)、住院时间更长(P<0.001)。PA与BMI、Alb、Hb、骨骼肌、BCM、BMC、SMI、FFM呈正相关(P<0.05),与浮肿指数、CRP及ESR呈负相关(P<0.001)。低PA(OR=0.016,P=0.047)和低FFM(OR=0.528,P=0.006)是UC病人发生营养不良的危险因素。结论:PA可以较好的预测住院UC病人营养不良,低PA组UC病人更容易合并营养不良、人体成分不同程度降低,炎症指标更高,住院时间及费用更高,可推荐PA作为住院UC病人营养评估的常规检测指标。Objective:To investigate the application value of bioelectrical impedance Phase angle in nutritional assessment of patients with hospitalized ulcerative colitis.Methods:In total,115 hospitalized ulcerative colitis hospitalized patients from September 2019 to March 2023 were included.Clinical factors,nutritional indexes(physical measurements,laboratory examination and body composition)were collected,and the PA value was measured.Malnutrition was assessed according to the GLIM criteria.According to the level of PA,UC patients were divided into normal PA group and low PA group.The differences of indicators between the two groups and the association between nutritional indexes,body composition and PA,risk factors for malnutrition in UC patients were analyzed.Results:40(34.78%)patients were in low PA group and 75(65.22%)patients were in normal PA group.In females,when PA≤4.57°was taken as cut-off value,the sensitivity was 0.778 and the specificity was 0.905.When PA≤5.48°was taken as cut-off value,the sensitivity was 0.784 and the specificity was 0.812 in males.Compared with the normal PA group,the proportion of malnourished patients in low PA group was higher(P<0.001).The levels of BMI,Alb,PAB and Hb were lower(P<0.05);skeletal muscle,BCM,BMC,waist circumference,SMI and FFM were decreased in different degrees(P<0.05),and the edema index was higher(P<0.001).The proportion of severe disease activity and the modified Mayo score were higher(P<0.01).The levels of CRP and ESR were higher(P<0.05).Hospitalization costs were higher(P<0.001)and hospital stays were longer(P<0.001).PA was positively correlated with BMI,Alb,Hb,skeletal muscle,BCM,BMC,SMI and FFM(P<0.05),and negatively correlated with edema index,CRP and ESR(P<0.001).Low PA(OR=0.016,P=0.047)and low FFM(OR=0.528,P=0.006)were risk factors for malnutrition in UC patients.Conclusions:PA can better predict malnutrition in hospitalized UC patients,and UC patients with low PA are more likely to be combined with malnutrition,lower body composition in different degree

关 键 词：溃疡性结肠炎 营养不良 人体成分 相位角 

分 类 号：R459.3[医药卫生—治疗学] R574.62[医药卫生—临床医学]