St-Arnaud McKenzie D, Kergoat M-J, Dube L, Ferland G
Centre de recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada.
J Nutr Health Aging. 2009 Feb;13(2):83-8. doi: 10.1007/s12603-009-0012-2.
To determine if changes in patients' nutritional status during hospitalization are related to daily energy and protein intakes when cachectic/inflammatory conditions are controlled for.
Prospective study.
A total of 32 non-cachectic patients (21 women; 65-92 y).
Nutritional status was evaluated at admission and discharge using the Protein-Energy Malnutrition Index which includes BMI, %IBW, TS, MAC, albumin, hemoglobin and lymphocyte count. Food intake was assessed 3 meals/day every other day for an average of 46.2 +/- 14.6 meals/participant.
In all, 47% of the study sample was malnourished at admission. Nutritional status improved in 73% of patients who had been identified as malnourished and in 30 % of non-malnourished patients at admission. Total energy intake correlated with improvements in BMI, %IBW and total lymphocyte count (all p < 0.04). Improvement in PEMI score for the whole group was associated with functional status (p < 0.05). Controlling for this variable, energy (kj/kg body weight) and protein (g/kg body weight) intakes correlated positively with improvements in BMI, %IBW and MAC (Energy: partial r = 0.644, 0.624, 0.466 respectively; Protein: partial r = 0.582, 0.554, 0.433 respectively; all p < 0.05).
Results from this study offer strong evidence that when cachectic/inflammatory conditions are controlled for, standard nutrition care is compatible with the maintenance or improvement of nutritional status during the hospital stay.
在控制恶病质/炎症状态的情况下,确定住院患者营养状况的变化是否与每日能量和蛋白质摄入量相关。
前瞻性研究。
共32名非恶病质患者(21名女性;年龄65 - 92岁)。
入院时和出院时使用蛋白质 - 能量营养不良指数评估营养状况,该指数包括体重指数(BMI)、理想体重百分比(%IBW)、三头肌皮褶厚度(TS)、上臂围(MAC)、白蛋白、血红蛋白和淋巴细胞计数。每隔一天评估患者一天三餐的食物摄入量,每位参与者平均评估了46.2±14.6餐。
总体而言,47%的研究样本在入院时营养不良。在入院时被确定为营养不良的患者中,73%的患者营养状况得到改善,在入院时非营养不良的患者中,这一比例为30%。总能量摄入量与BMI、%IBW和总淋巴细胞计数改善相关(均p<0.04)。全组蛋白质 - 能量营养不良指数(PEMI)评分的改善与功能状态相关(p<0.05)。控制该变量后,能量(千焦/千克体重)和蛋白质(克/千克体重)摄入量与BMI、%IBW和MAC的改善呈正相关(能量:偏相关系数分别为0.644、0.624、0.466;蛋白质:偏相关系数分别为0.582、0.554、0.433;均p<0.05)。
本研究结果提供了强有力的证据,即在控制恶病质/炎症状态时,标准营养护理与住院期间维持或改善营养状况是相容的。