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失代偿期肝硬化患者营养状况及免疫功能的临床观察

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目的 探讨失代偿期肝硬化住院患者营养状况及免疫功能情况。方法 选取2020年1月至2022年6月于该院住院的132例失代偿期肝硬化患者。通过营养风险筛查2002(NRS2002)评分将其分为高营养风险组、低营养风险组和无营养风险组。对比分析3组患者各项营养指标、细胞免疫指标、肝功能Child-Pugh分级和并发症的情况。结果 高营养风险组和低营养风险组的BMI、肱三头肌皮皱厚度(TSF)TSF、上臂肌围(AMC)、血红蛋白(Hb)、清蛋白(ALB)、前清蛋白(PA)、视黄醇结合蛋白(RBP)、甘油三酯(TG)均低于无营养风险组,低营养风险组的BMI、TSF、AMC低于无营养风险组,高营养风险组ALB、TG低于低营养风险组,差异有统计学意义(P<0。05);高营养风险组和低营养风险组的免疫指标IgG、IgA高于无营养风险组,差异有统计学意义(P<0。05);高营养风险组和低营养风险组CD4+T细胞百分比、CD4+T细胞百分比与CD8+T细胞百分比的比值(CD4+T/CD8+T)均低于无营养风险组,差异有统计学意义(P<0。05);NRS2002评分与BMI、TSF、AMC、Hb、ALB、PA、RBP、胆固醇(TC)、TG、CD4+T、CD4+T/CD8+T呈负相关(P<0。05);与IgG、IgA、IgM呈正相关(P<0。001);多元逐步回归分析发现Hb、TSF、AMC、ALB、RBP与NRS2002评分存在线性回归关系。结论 高营养风险失代偿期肝硬化患者的营养状况及免疫功能较差,及时对高营养风险失代偿期肝硬化患者进行营养干预是非常有必要的。
Clinical observation of nutritional status and immune function in patients with decompensated cirrhosis
Objective To explore the nutritional status and immune function of hospitalized patients with decompensated cirrhosis.Methods A total of 132 patients with decompensated cirrhosis who were hospi-talized in this hospital from January 2020 to June 2022 were selected.According to Nutritional Risk Screening 2002 (NRS2002) score,the patients were divided into the high-nutritional-risk group,the low-nutritional-risk group,and the non-nutritional-risk group.Comparative analysis was conducted on nutritional status indica-tors,cellular immune indicators,Child-Pugh classification of liver function,and complications among the three groups.Results BMI,TSF,AMC,Hb,ALB,PA,RBP and TG in the high-nutritional-risk group and low-nu-tritional-risk group were lower than those in the non-nutritional-risk group.BMI,TSF,and AMC in the low-nutritional-risk group were lower than those in the non-nutritional-risk group.ALB and TG in the high-nutri-tional-risk group were lower than those in the low-nutritional-risk group,with statistically significant differ-ences (P<0.05).The immune indexes IgG and IgA in the high-nutritional-risk group and the low-nutritional-risk group were higher than those in the non-nutritional-risk group,with statistically significant differences (P<0.05).The percentage of CD4+T cells and the ratio of CD4+T cells to CD8+T cells (CD4+T/CD8+T) in the high-nutritional-risk group and the low-nutritional-risk group were lower than those in the non-nutrition-al-risk group,with statistically significant differences (P<0.05).The NRS2002 score was negatively correla-ted with BMI,TSF,AMC,Hb,ALB,PA,RBP,TC,TG,CD4+T,CD4+T/CD8+T (P<0.05).It was positive-ly correlated with IgG,IgA,IgM (P<0.001).Multivariate stepwise regression analysis showed that there was a linear regression relationship between Hb,TSF,AMC,ALB,RBP,and NRS2002 score.Conclusion The nu-tritional status and immune function of patients with high nutritional risk decompensated cirrhosis are poor.It is necessary to carry out nutritional intervention in patients with high nutritional risk decompensated cirrhosis in time.

decompensated cirrhosisnutritional statusimmune functionliver function

叶婷、罗雪清、黄美金

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失代偿期肝硬化 营养状况 免疫功能 肝功能

广西壮族自治区卫生健康委自筹经费课题

Z20200278

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(9)