Unosson M, Ek A C, Bjurulf P, von Schenck H, Larsson J
Department of Caring Sciences, Faculty of Health Sciences, University of Linköping, Sweden.
Stroke. 1994 Feb;25(2):366-71. doi: 10.1161/01.str.25.2.366.
We assessed the nutritional status of patients with acute stroke and evaluated it in relation to the patients' dependence on assistance with feeding.
Fifty patients aged 70 years or older, admitted from their homes, were included. Weight index, triceps skinfold thickness, arm muscle circumference, serum proteins, delayed hypersensitivity, body composition measured by bioelectric impedance, and functional condition were determined on admission and 2 and 9 weeks after admission. Food and fluid consumption were also recorded.
On admission, four patients were regarded as protein-energy malnourished. Those who required assistance with feeding after admission (n = 18, 36%) had lower serum albumin (P < .05), lower body cell mass (P < .01), and were more anergic than the independent patients (P < .01) on admission. The mean food consumption was 72% of the food served without significant difference between dependent and independent patients. Nine weeks after the onset of stroke symptoms, the patients who were dependent on assisted feeding showed a decrease in body cell mass. The loss of body cell mass was related to their activity and feeding dependence.
Low serum albumin and anergy commonly occur in elderly patients with acute stroke, and they occur more prevalently among those with a severely impaired functional condition. During the recovery period, the patients use body fat to compensate for energy needs, and immobility leads to loss of body cell mass.
我们评估了急性中风患者的营养状况，并根据患者在进食方面对他人帮助的依赖程度进行评估。
纳入50名70岁及以上从家中收治入院的患者。在入院时、入院后2周和9周测定体重指数、肱三头肌皮褶厚度、上臂肌肉周长、血清蛋白、迟发型超敏反应、通过生物电阻抗测量的身体成分以及功能状况。还记录了食物和液体摄入量。
入院时，4名患者被视为蛋白质 - 能量营养不良。入院后需要喂食帮助的患者（n = 18，36%）在入院时血清白蛋白较低（P < 0.05），身体细胞量较低（P < 0.01），且比独立进食的患者更无反应性（P < 0.01）。平均食物摄入量为所供应食物的72%，依赖喂食和独立进食的患者之间无显著差异。中风症状出现9周后，依赖辅助喂食的患者身体细胞量减少。身体细胞量的减少与他们的活动和喂食依赖有关。
血清白蛋白水平低和无反应性在老年急性中风患者中普遍存在，且在功能状况严重受损的患者中更常见。在恢复期间，患者利用身体脂肪来补偿能量需求，而活动减少导致身体细胞量丢失。
