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营养相关标志物与缺血性脑卒中后接受肠内营养患者的结局:一项回顾性队列研究。

Nutrition-associated markers and outcomes among patients receiving enteral nutrition after ischemic stroke: a retrospective cohort study.

机构信息

Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.

West China School of Nursing, Sichuan University, Chengdu, China.

出版信息

BMC Neurol. 2024 Aug 30;24(1):303. doi: 10.1186/s12883-024-03812-y.

Abstract

BACKGROUND

Early nutrition after acute ischemic stroke is crucial. We explored early enteral nutrition for stroke patients and evaluated changes in blood indicators as a predictor of stroke prognosis.

METHODS

All hospitalized stroke patients receiving enteral nutrition were included in the study. We retrospectively collected the protein, energy, fat, and carbohydrate values for 7 days after admission. Serum albumin, total protein, and hemoglobin values were reviewed at admission and at one week. The main outcome indicators were the Modified Rankin Score, Barthel Index, and Quality of Life at 3 months.

RESULTS

A total of 354 patients (mean age, 70.7 years; 59.0% male) were included. The change in serum albumin at day 7 relative to at admission was positively correlated with the Quality of Life score (p = 0.001), the Barthel Index (p = 0.004), and the modified Rankin Score (p = 0.029). The change in total protein at day 7 relative to at admission was positively correlated with the Quality of Life score (p = 0.002), the Barthel Index (p = 0.001), and the modified Rankin score (p = 0.011). The change in hemoglobin values at day 7 relative to at admission was positively correlated with the Barthel Index (p = 0.037 but not with the Quality of Life score (p = 0.237) or the modified Rankin score (p = 0.730).

CONCLUSIONS

Improved nutrition-related blood indicators one week after admission were independently associated with good stroke outcomes. Nutritional support for acute ischemic stroke patients during the early hospitalization stage appears to be advisable.

TRIAL REGISTRATION

This review was a retrospective cohort study. The study was retrospectively registered in the Chinese Clinical Trial Registry (No: ChiCTR2300077228). Registration date: 1/11/2023.

摘要

背景

急性缺血性脑卒中后早期营养至关重要。我们探讨了脑卒中患者的早期肠内营养,并评估了血液指标的变化作为脑卒中预后的预测指标。

方法

所有接受肠内营养的住院脑卒中患者均纳入本研究。我们回顾性收集了入院后第 7 天的蛋白质、能量、脂肪和碳水化合物值。入院时和第 1 周复查血清白蛋白、总蛋白和血红蛋白值。主要结局指标为 3 个月时的改良 Rankin 评分、Barthel 指数和生活质量。

结果

共纳入 354 例患者(平均年龄 70.7 岁,59.0%为男性)。第 7 天血清白蛋白与入院时相比的变化与生活质量评分(p=0.001)、Barthel 指数(p=0.004)和改良 Rankin 评分(p=0.029)呈正相关。第 7 天总蛋白与入院时相比的变化与生活质量评分(p=0.002)、Barthel 指数(p=0.001)和改良 Rankin 评分(p=0.011)呈正相关。第 7 天血红蛋白值与入院时相比的变化与 Barthel 指数呈正相关(p=0.037),但与生活质量评分(p=0.237)或改良 Rankin 评分(p=0.730)无关。

结论

入院后第 1 周营养相关血液指标的改善与良好的脑卒中预后独立相关。急性缺血性脑卒中患者在早期住院阶段进行营养支持似乎是合理的。

试验注册

本综述为回顾性队列研究。该研究在中国临床试验注册中心(注册号:ChiCTR2300077228)进行了回顾性注册。注册日期:2023 年 1 月 11 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cb1/11363362/e67275f3ff4d/12883_2024_3812_Fig1_HTML.jpg

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