在患有压疮的养老院老年人中，免疫功能会因表明营养不良的微型营养评定分数而受损。

Immune function is impaired with a mini nutritional assessment score indicative of malnutrition in nursing home elders with pressure ulcers.

作者信息

Hudgens Jan, Langkamp-Henken Bobbi, Stechmiller Joyce K, Herrlinger-Garcia Kelli A, Nieves Carmelo

机构信息

Food Science and Human Nutrition, University of Florida, Gainesville, Florida 32611-0370, USA.

出版信息

JPEN J Parenter Enteral Nutr. 2004 Nov-Dec;28(6):416-22. doi: 10.1177/0148607104028006416.

DOI:10.1177/0148607104028006416

PMID:15568288

Abstract

BACKGROUND

Malnutrition is prevalent in elders with pressure ulcers and is associated with increased morbidity and mortality. This study compared nutritional status, assessed by the Mini Nutrition Assessment (MNA), to immune function in nursing home elders with pressure ulcers.

METHODS

Nutritional status was assessed in nursing home residents (>65 years) with a stage II or more severe pressure ulcer. Subjects were classified as well nourished, at risk of malnutrition, or malnourished according to MNA score. Blood was drawn to assess whole blood mitogen-induced lymphocyte proliferation and neutrophil respiratory burst. Delayed-type hypersensitivity to 3 antigens was measured. MNA status was compared with immune parameters using the Kruskall-Wallis test.

RESULTS

Of the 24 subjects (23 men, 1 woman) who completed the study protocol, only 4 (17%) were classified as well nourished, whereas 7 (29%) were at risk and 13 (54%) were malnourished according to MNA score. Whole blood lymphocyte proliferation was significantly lower in the malnourished vs at risk subjects with both pokeweed (median [25th, 75th percentile], 0.6 [0.3, 0.9] vs 1.8 [1.2, 2.1] disintegrations per minute [dpm]/cell, p < .05); and concanavalin A (1.7 [0.9, 2.0] vs 2.8 [2.6, 3.9] dpm/cell, p < .05) mitogens. Neutrophil respiratory burst normalized to a young control was significantly lower in malnourished subjects vs well-nourished subjects (0.8 [0.5, 0.9] vs 1.4 [1.0, 1.7], p < .05). Total induration to 3 skin-test antigens was 13.4 +/- 4.6, 3.5 +/- 2.6, and 3.8 +/- 1.8 (mean +/- SEM) for well-nourished, at risk, and malnourished, respectively (p = .059).

CONCLUSIONS

Immune function is impaired with an MNA score indicative of malnutrition in nursing home elders with pressure ulcers.

摘要

背景

营养不良在患有压疮的老年人中普遍存在，且与发病率和死亡率增加相关。本研究比较了通过微型营养评定法（MNA）评估的营养状况与疗养院中患有压疮的老年人的免疫功能。

方法

对疗养院中患有II期或更严重压疮的居民（年龄>65岁）进行营养状况评估。根据MNA评分将受试者分为营养良好、有营养不良风险或营养不良。采集血液以评估全血有丝分裂原诱导的淋巴细胞增殖和中性粒细胞呼吸爆发。测量对3种抗原的迟发型超敏反应。使用Kruskal-Wallis检验比较MNA状态与免疫参数。

结果

在完成研究方案的24名受试者（23名男性，1名女性）中，根据MNA评分，只有4名（17%）被归类为营养良好，而7名（29%）有风险，13名（54%）营养不良。营养不良受试者的全血淋巴细胞增殖明显低于有风险受试者，对于商陆（中位数[第25百分位数，第75百分位数]，0.6[0.3，0.9]对1.8[1.2，2.1]每分钟细胞崩解数[dpm]/细胞，p<.05）；以及伴刀豆球蛋白A（1.7[0.9，2.0]对2.8[2.6，3.9]dpm/细胞，p<.05）有丝分裂原。与营养良好的受试者相比，营养不良受试者中归一化至年轻对照的中性粒细胞呼吸爆发明显更低（0.8[0.5,].9]对1.4[1.0，1.7]，p<.05）。对于营养良好、有风险和营养不良的受试者，对3种皮肤试验抗原的总硬结分别为13.4±4.6、3.5±2.6和3.8±1.8（平均值±标准误）（p=.059）。