营养风险与慢性阻塞性肺疾病频繁急性加重的关系研究  

Correlation between nutritional risk and frequent acute exacerbation of COPD

作　　者：刘海月 李凤 林益华 刘祖恒[2,5] LIU Haiyue;LI Feng;LIN Yihua;LIU Zuheng(Department of Clinical Laboratory,First Affiliated Hospital of Xiamen University/Xiamen Municipal Key Laboratory of Genetic Testing,Xiamen,Fujian 361000,China;School of Medicine,Xiamen University,Xiamen,Fujian 361000,China;Department of Nutrition,Affiliated Xiamen Cardiovascular Hospital of Xiamen University,Xiamen,Fujian 361000,China;Department of Respiratory and Critical Care Medicine,First Affiliated Hospital,Xiamen University,Xiamen,Fujian 361000,China;Department of Cardiology,First Affiliated Hospital,Xiamen University/Xiamen Municipal Institute of Cardiovascular Diseases/Xiamen Municipal Key Laboratory of Cardiac Electrophysiology,Xiamen,Fujian 361000,China)

机构地区：[1]厦门大学附属第一医院检验科/厦门市基因检测重点实验室,福建厦门361000 [2]厦门大学医学院,福建厦门361000 [3]厦门大学附属心血管病医院营养科,福建厦门361000 [4]厦门大学附属第一医院呼吸与危重症医学科,福建厦门361000 [5]厦门大学附属第一医院心血管内科/厦门市心血管病研究所/厦门市心脏电生理重点实验室,福建厦门361000

出　　处：《重庆医学》2025年第2期335-339,共5页Chongqing Medical Journal

基　　金：国家自然科学基金项目(82202629,82100385);福建省自然科学基金项目(2021J05287,2021J05283);福建省卫生健康科技计划项目(2021QNB016)。

摘　　要：目的 探讨营养风险与慢性阻塞性肺疾病(COPD)频繁急性加重风险的关系。方法 收集厦门大学附属第一医院呼吸与危重症医学科住院的慢性阻塞性肺疾病急性加重期(AECOPD)患者,分为频繁急性加重风险组(FE组)与非频繁急性加重风险组(NE组),基于营养风险筛查量表-2002(NRS-2002)评分评估营养风险(1~2分为无营养风险,3~7分为有营养风险)。通过单因素与多因素logistic回归分析探讨两者的关系。结果 FE组住院时间更长(P<0.01),高血压患者比例更高(P<0.01)。炎症指标方面,FE组中性粒细胞与白蛋白比值(NAR)、血小板与淋巴细胞比值(PLR)均明显上升(P<0.05);而营养状况方面,FE组NRS-2002评分显示更高比例的营养风险人群(P<0.01),同时总蛋白与白蛋白(Alb)水平明显降低(P<0.05)。经调整性别、住院时间、炎症指标及基础疾病史等混杂因素后,全因素logistic回归分析显示,存在营养风险的COPD患者频繁急性加重的风险明显高于无营养风险的患者(OR=2.948,95%CI:1.112~7.816,P<0.05)。结论 NRS-2002评分存在营养风险的COPD患者相较于无营养风险者,频繁急性加重风险明显增加。Objective To explore the relationship between the nutritional risk and the risk of frequent acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods The patients with acute exacerbation of COPD(AECOPD)hospitalized in the respiratory and critical care medicine department of the First Affiliated Hospital of Xiamen University were collected and divided into the frequent acute exacerbation risk group(FE)and non-frequent exacerbation risk group(NE).The nutritional risk was evaluated by the Nutritional Risk Screening Scale-2002(NRS-2002)(1-2 points as no nutritional risk,3-7 points as nutritional risk).The relationship between the two was analyzed by statistics and logistic regression.Results The FE group had longer hospital stay(P<0.01)and a higher proportion of hypertension(P<0.01).In terms of inflammatory indicators,the neutrophil to albumin ratio(P<0.01)and platelet to lymphocyte ratio(P<0.05)in the FE group were significantly increased.In the aspect of nutritional status,the NRS-2002 score in the FE group showed a higher proportion of nutritional risk population(P<0.01),meanwhile the total protein(P<0.01)and albumin(P<0.05)levels were significantly decreased.After adjusting the confounding factors such as gender,hospitalization duration,inflammatory markers and history of underlying diseases,the full factor logistic regression analysis revealed that the frequent acute exacerbation risk in COPD patients with nutritional risk was significantly higher that in the patients with no nutritional risk[odds ratio(OR)=2.948;95%confidence interval(95%CI):1.112-7.816;P<0.05].Conclusion The COPD patients with nutritional risk in NRS-2002 scores exhibit a significantly increased risk of frequent acute exacerbation compared to those without nutritional risk.

关 键 词：慢性阻塞性肺疾病 频繁急性加重风险 NRS-2002营养风险筛查 中性粒细胞与白蛋白比值 血小板与淋巴细胞比值 

分 类 号：R563.9[医药卫生—呼吸系统]