2型糖尿病伴大血管病变患者的营养情况及营养风险模型构建  

Nutritional status and nutritional risk model constructionin patients with type 2 diabetes mellitus and macroangiopathy

作　　者：荀子雪 胡大玲 XUN Zixue;HU Daling(Sir Run Run Hospital,Nanjing Medical University,Nanjing,Jiangsu,210000,China)

机构地区：[1]南京医科大学附属逸夫医院,江苏南京210000

出　　处：《中西医结合护理(中英文)》2024年第12期5-8,共4页Journal of Clinical Nursing in Practice

摘　　要：目的评估2型糖尿病伴大血管病变患者的营养情况,并构建营养风险模型。方法选取南京医科大学附属逸夫医院于2021年3月至2023年3月收治的266例2型糖尿病患者,按照其是否合并大血管病变分为观察组(127例)及对照组(139例),并将观察组患者按照3∶1比例随机分入模型组(95例)及验证组(32例)。对比观察组和对照组的身体质量指数(BMI)、血红蛋白(Hb)等营养指标,并比较模型组营养风险筛查量表(NRS 2002)评分≥3分、<3分患者的临床资料,使用多因素Logistic回归模型总结影响患者营养风险的相关因素。基于风险因素构建列线图,使用验证组数据行模型验证。结果观察组的Hb、前白蛋白和白蛋白水平均低于对照组(P均<0.05)。模型组95例患者中,27例患者的NRS 2002评分≥3分,占28.42%。多因素回归分析示,年龄、病程、空腹血糖、餐后2 h血糖、糖化血红蛋白、甘油三酯以及合并冠状动脉粥样硬化性心脏病均是2型糖尿病伴大血管病变患者发生营养风险的影响因素(P均<0.05)。基于Logistic回归建立的列线图模型拟合优度检验示,模型校准度良好,且其区分度和内部验证结果良好。结论2型糖尿病伴大血管病变患者普遍较单纯糖尿病患者的营养状况更差,且近1/3的患者存在高营养不良风险,这与患者年龄、病程等多种因素有关,基于风险因素的综合评估能够为患者营养风险预测提供可靠参考。Objective To evaluate the nutritional status of patients with type 2 diabetes mellitus and macroangiopathy,and to construct a nutritional risk model.Methods A total of 266 patients with type 2 diabetes mellitus who were admitted to Sir Run Run Hospital,Nanjing Medical University from March 2021 to March 2023 were enrolled.They were allocated to the observation group(127 cases)and the control group(139 cases)according to whether they had macroangiopathy or not,and the patients in the observation group were randomly allocated to the model group(95 cases)and the validation group(32 cases)at a ratio of 3∶1.The nutritional indicators such as body mass index(BMI)and hemoglobin(Hb)were compared between the observation group and the control group,and the clinical data of patients with Nutritional Risk Screening 2002(NRS 2002)score≥3 and<3 in the model group were compared.A multiple logistic regression model was used to summarize the relevant influencing factors of nutritional risk of patients.A nomogram was constructed based on risk factors and the model was validated using the data of validation group.Results The levels of Hb,prealbumin,and albumin in the observation group were all lower than those in the control group(all P<0.05).Among the 95 patients in the model group,27 patients had a NRS 2002 score≥3,accounting for 28.42%.Multiple regression analysis showed that age,course of disease,fasting blood glucose,2-h postprandial blood glucose,glycosylated hemoglobin,triglycerides,and coronary atherosclerotic heart disease were the influencing factors of nutritional risk of patients with type 2 diabetes mellitus and macroangiopathy(all P<0.05).The goodness of fit test of nomogram model based on logistic regression showed that the calibration of the model was good,and its discrimination and internal validation results were good.Conclusion The nutritional status of patients with type 2 diabetes mellitus and macroangiopathy is generally worse than that of patients with type 2 diabetes mellitus alone,and nearly 1/3 of th

关 键 词：2型糖尿病 大血管病变 营养情况 营养风险模型 

分 类 号：R587.1[医药卫生—内分泌]