老年慢性阻塞性肺疾病患者营养风险与衰弱的横断面研究  

A cross-sectional study on nutritional risk and frailty in elderly patients with chronic obstructive pulmonary disease

作　　者：刘灵芳 方燕红[1] 董佳[1] 殷瑶 郑星 王睿珊 龚相丹 江红霞 程真顺[1] 吴长蓉[1] LIU Lingfang;FANG Yanhong;DONG Jia;YIN Yao;ZHENG Xing;WANG Ruishan;GONG Xiangdan;JIANG Hongxia;CHENG Zhenshun;WU Changrong(Dept.of Respiratory and Critical Care Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院呼吸与危重症医学科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2024年第9期1082-1087,共6页Medical Journal of Wuhan University

基　　金：国家自然科学基金资助项目(编号:82070062);武汉大学中南医院护理学科培育课题资助项目(编号:HLXKPY202109)。

摘　　要：目的:了解老年慢性阻塞性肺疾病(COPD)患者的营养状况及衰弱情况,探讨老年COPD营养风险的影响因素及其营养状况与衰弱的相关性。方法:采用便利抽样的方法,选取2021年12月—2022年12月在武汉大学中南医院住院的老年COPD患者为研究对象,以营养风险筛查表(NRS2002)量表及FRAIL衰弱量表对老年COPD患者进行营养风险筛查及衰弱情况调查,并收集患者白蛋白、血清C反应蛋白指标,统计患者性别、年龄、体质量指数(BMI)、急性发病次数等参数。通过Kendall's tau-b分析患者衰弱状况与营养风险之间是否存在相关性,通过二分类Logistic回归来分析患者营养风险的影响因素。结果:120例老年COPD患者中,60.83%(73/120)的患者存在营养风险,65%(78/120)的患者存在衰弱,且其营养风险与衰弱存在正相关关系(r=0.739)。营养风险组患者的衰弱得分、白蛋白水平、BMI等低于无营养风险组患者,而平均年龄、血清C反应蛋白水平、1年内急性发病次数等高于无营养风险组患者,差异均有统计学意义(P<0.05)。衰弱状况、白蛋白水平、BMI、年龄、血清C反应蛋白与白蛋白比值(CAR)、急性发病次数等因素对老年COPD患者营养风险的发生有显著影响(P<0.05)。结论:老年COPD患者营养风险及衰弱发生率高,其营养风险与衰弱情况相关,医护人员应重点关注老年COPD患者营养状况、白蛋白水平及炎症指标,并实施阶段化干预措施,动态化营养管理,降低衰弱率,改善患者的营养状态。Objective:To investigate the nutritional status and frailty of elderly patients with chronic ob-structive pulmonary disease(COPD),and to explore the influencing factors of nutritional risk in elder-ly patients with COPD and the correlation between nutritional status and frailty.Methods:From De-cember 2021 to December 2022,convenience sampling was used to select elderly COPD patients hos-pitalized in Zhongnan Hospital of Wuhan University as the research objects.The Nutritional Risk Screening 2002(NRS2002)scale and FRAIL Frailty scale were used respectively to screen the nutri-tional risk and investigate the frailty of elderly COPD patients.Serum albumin,C-reactive protein,and other indicators of patients were collected,and parameters such as gender,age,body mass index(BMI),and the number of acute episodes of patients were counted.Kendall's tau-b was used to ana-lyze whether there was a correlation between frailty and nutritional risk,and binary logistic regression was used to analyze the influencing factors of nutritional risk.Results:Among the 120 elderly patients with COPD,60.83%(73/120)had nutritional risk and 65%(78/120)had frailty,and there was a positive correlation between nutritional risk and frailty(r=0.739).The frailty score,albumin level,and BMI of patients in the nutritional risk group were lower than those in the non-nutritional risk group,while the average age,serum C-reactive protein level,and the times of acute onset within one year were higher than those in the non-nutritional risk group(P<0.05).Age,BMI,times of acute on-set,albumin,serum C-reactive protein to albumin ratio(CAR),and frailty status had a significant im-pact on the occurrence of nutritional risk in elderly COPD patients(P<0.05).Conclusion:The nutri-tional risk is related to frailty in elderly patients with COPD.Medical and nursing staff should pay at-tention to the nutritional status,albumin level,and inflammatory indicators of the patients,and imple-ment phased intervention measures and dynamic nutritional management to reduce the

关 键 词：慢性阻塞性肺疾病 衰弱 营养状况 白蛋白 血清C反应蛋白 

分 类 号：R563.9[医药卫生—呼吸系统]