存在营养风险呼吸系统疾病患者不同启动时间营养干预效果比较  

Comparison of nutritional intervention effects at different initiation time in patients with respiratory diseases at nutritional risk

作　　者：王利红 崔源[1] 火少晔 赵蕴华[1] 魏玉环[1] 蒋蓉 邵春海 WANG Lihong;CUI Yuan;HUO Shaoye;ZHAO Yunhua;WEI Yuhuan;JIANG Rong;SHAO Chunhai(Department of Clinical Nutrition,Shanghai Fifth People’s Hospital,Fudan University,Shanghai 200240,China;Centre for Community Health Research,Fudan University,Shanghai 200240,China;Department of Respiratory Medicine,Shanghai Fifth People’s Hospital,Fudan University,Shanghai 200240,China;Department of Clinical Nutrition,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属上海市第五人民医院临床营养科,上海200240 [2]复旦大学社区健康研究中心,上海200240 [3]复旦大学附属上海市第五人民医院呼吸内科,上海200240 [4]复旦大学附属华山医院临床营养科,上海200040

出　　处：《中国临床医学》2025年第2期268-275,共8页Chinese Journal of Clinical Medicine

基　　金：2019年复旦大学附属上海市第五人民医院院内科研课题助推项目(2019WYZT01)。

摘　　要：目的评估尽早营养干预对存在营养风险呼吸系统疾病患者的效果。方法选择2023年5月至2024年12月在复旦大学附属上海市第五人民医院住院且营养风险筛查2002评分≥3分的130例患者。根据营养干预的启动时间,将患者分为早期组(营养干预启动≤5 d,n=65)和晚期组(营养干预启动>5 d,n=65)。结果早期组干预后,患者前白蛋白(P-ALB)和视黄醇结合蛋白(RBP)水平升高(P<0.01),C反应蛋白(CRP)、降钙素原(PCT)水平降低(P<0.05)。与晚期组相比,早期组患者住院费用减少、住院时间缩短(P<0.001)。Spearman分析显示,ALB、P-ALB、血清总蛋白(TP)与住院费用负相关(r=-0.37、-0.20、-0.22,P<0.05);RBP、ALB、P-ALB、淋巴细胞计数(LYM)与CRP负相关(r=-0.30、-0.26、-0.37、-0.18,P<0.01),RBP、ALB、P-ALB、血红蛋白(HB)、TP与PCT负相关(r=-0.23、-0.36、-0.40、-0.30、-0.19,P<0.05)。结论尽早对呼吸系统疾病患者进行营养评估,对其中营养风险筛查2002评分≥3分者尽早干预,有助于改善其营养状况和降低炎症水平,促进康复,减少住院费用。Objective To assess the effect of early nutritional intervention on the patients with respiratory diseases at nutritional risk.Methods A total of 130 patients with respiratory disease who were hospitalized in Shanghai Fifth People’s Hospital,Fudan University between May 2023 and December 2024 and had a nutritional risk screening 2002 score≥3 points.Based on the initiation time of nutritional intervention,patients were divided into an early group(≤5 days,n=65)and a late group(>5 days,n=65).Results In the early group,prealbumin(P-ALB)and retinol-binding protein(RBP)levels were significantly higher(P<0.01),C-reactive protein(CRP),procalcitonin(PCT)levels were significantly lower after intervention(P<0.05).Compared with the late group,the hospital costs were lower and hospital stays were shorter in the early group(P<0.001).Spearman analysis showed ALB,P-ALB,and total protein(TP)were negatively correlated with hospital costs(r=-0.37,-0.20,and-0.22,P<0.05).RBP,ALB,P-ALB,and lymphocyte count(LYM)were negatively correlated with CRP(r=-0.30,-0.26,-0.37,-0.18,P<0.01),RBP,ALB,P-ALB,hemoglobin(HB),and TP were negatively correlated with PCT(r=-0.23,-0.36,-0.40,-0.30,-0.19,P<0.05).Conclusions For patients with respiratory diseases,early nutritional assessment should be underwent,and for patients with nutritional risk screening 2002 score≥3 points,early nutritional intervention could improve the nutritional status and alleviate inflammatory response,promote recovery,shorten the hospital stays.

关 键 词：营养干预 启动时间 呼吸系统疾病 炎症反应 营养状态 

分 类 号：R459.3[医药卫生—治疗学] R56[医药卫生—临床医学]