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内科患者的营养状况与体能

Nutritional status and performance capacity in internal medical patients.

作者信息

Cederholm T, Jägrén C, Hellström K

机构信息

Department of Medicine, Karolinska Institute, Stockholm Söder Hospital, S-118 83 Stockholm, Sweden.

出版信息

Clin Nutr. 1993 Feb;12(1):8-14. doi: 10.1016/0261-5614(93)90138-t.

Abstract

The nutritional status (3 anthropometric records, serum albumin and delayed cutaneous hypersensitivity (DCH)), recent weight loss, dynamometric capacity and mood were assessed in 205 recently admitted non-cancer internal medical patients. 20% of the subjects were classified as malnourished (3 of the 5 nutritional variables below the reference range). The occurrence of malnutrition was higher (1/3) in multiple organ dysfunction or chronic respiratory disease. In order to reduce the risk of overestimating malnutrition, the data for serum albumin and DCH were omitted when they appeared to be influenced by non-nutritional factors. Disease duration >2 years, old age and multiple organ dysfunction were independently related to malnutrition. Serum albumin correlated more strongly with the acute phase reactant, serum acid glycoprotein (r = 0.33, P < 0.001) than with the anthropometric variables (r < 0.24). Recalled recent weight loss >5% was found in 34% of the malnourished subjects. Malnourished, in comparison to well nourished patients, exhibited reduced (p < 0.05) recordings for hand grip strength, peak expiratory flow and time of ambulation. Depressive tendencies were seen in malnourished women (p < 0.05).

摘要

对205名新入院的非癌症内科患者的营养状况(三项人体测量记录、血清白蛋白和迟发性皮肤超敏反应(DCH))、近期体重减轻情况、握力和情绪进行了评估。20%的受试者被归类为营养不良(五项营养变量中有三项低于参考范围)。在多器官功能障碍或慢性呼吸道疾病患者中,营养不良的发生率更高(三分之一)。为降低高估营养不良风险,当血清白蛋白和DCH数据似乎受非营养因素影响时将其排除。疾病持续时间>2年、老年和多器官功能障碍与营养不良独立相关。血清白蛋白与急性期反应物血清酸性糖蛋白的相关性更强(r = 0.33,P < 0.001),而与人体测量变量的相关性较弱(r < 0.24)。34%的营养不良受试者近期体重减轻>5%。与营养良好的患者相比,营养不良患者的握力、呼气峰值流速和行走时间记录较低(p < 0.05)。营养不良的女性存在抑郁倾向(p < 0.05)。

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