Bistrian B R, Blackburn G L, Vitale J, Cochran D, Naylor J
JAMA. 1976 Apr 12;235(15):1567-70.
Three, single-day nutritional surveys at weekly intervals were conducted in the general medical wards of an urban municipal teaching hospital. The techniques of nutritional assessment included anthropometric measures (weight/height, triceps skin fold, arm-muscle circumference, serum albumin, and hematocrit). The prevalence of protein-calorie malnutrition was 44% or greater by these criteria (weight/height, 45%; triceps skin fold, 76%; arm-muscle circumference, 55%; serum albumin, 44%; and hematocrit, 48%). These results were reproducible without significant variation between surveys. In 34% of patients, a lymphopenia of 1,200 cells/cu mm or less was found, a level likely to be associated with diminished cell-mediated immunity. Compared with a similar survey among surgical patients, the medical patients were more depleted calorically (weight/height, triceps skin fold) but had better protein status (arm-muscle circumference, serum albumin). Significant protein-calorie malnutrition occurs commonly in municipal hospitals in both medical and surgical services.
在一家城市市级教学医院的普通内科病房,每隔一周进行了三次单日营养调查。营养评估技术包括人体测量指标(体重/身高、三头肌皮褶厚度、上臂肌肉周长、血清白蛋白和血细胞比容)。根据这些标准(体重/身高,45%;三头肌皮褶厚度,76%;上臂肌肉周长,55%;血清白蛋白,44%;血细胞比容,48%),蛋白质-热量营养不良的患病率为44%或更高。这些结果具有可重复性,不同调查之间无显著差异。在34%的患者中,发现淋巴细胞减少至每立方毫米1200个细胞或更少,这一水平可能与细胞介导的免疫功能减弱有关。与外科患者的类似调查相比,内科患者热量消耗更多(体重/身高、三头肌皮褶厚度),但蛋白质状况更好(上臂肌肉周长、血清白蛋白)。蛋白质-热量营养不良在市级医院的内科和外科服务中普遍存在。