摘要
目的 调查老年肺结核(tuberculosis,TB)合并肺部感染患者的营养状况并分析其影响因素.方法 回顾性分析 226 例老年TB合并肺部感染患者的临床资料,根据患者的营养评价精法(MNA-SF)评分将其分为营养良好组(107 例,MNA-SF≥11 分)和营养不良组(119 例,MNA-SF<11 分).比较两组一般资料,营养状况指标[血清白蛋白(Alb)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血红蛋白(Hb)、总淋巴细胞计数(TLC)以及C反应蛋白(CRP)]和肺功能指标[用力肺活量(FVC)、一秒用力呼气容积(FEV1)和第一秒用力呼气量占用力肺活量的比例(FEV1/FVC)]水平,采用Logistic回归法分析患者发生营养不良的独立危险因素.结果 老年TB合并肺部感染患者营养不良发生率为 52.65%(119/226).营养良好组患者TLC、Alb和Hb水平较营养不良组高,而TC、LDL-C、CRP水平及FVC、FEV1 和FEV1/FVC水平均较营养不良组低,差异有统计学意义(均P<0.05).Logistic回归分析结果显示,TLC、Alb和Hb水平过低以及TC、LDL-C、CRP水平过高均为患者发生营养不良的独立危险因素(P<0.05).结论 老年TB合并肺部感染营养不良患者体内TLC、Alb和Hb水平相对较低,TC、LDL-C和CRP水平相对较高,上述指标均会影响患者营养不良的发生.
Abstract
Objective To investigate the nutritional status of elderly patients with pulmonary tuberculosis(TB)and pulmonary infection,and to analyze the influencing factors.Methods A retrospective analysis was performed on the clinical data of 226 elderly patients with TB and pulmonary infection.Patients were categorized into two groups based on their mini nutritional assessment-short form(MNA-SF)scores:the well-nourished group(107 cases,MNA-SF≥11 points)and the malnourished group(119 cases,MNA-SF<11 points).General information,nutritional status indicators[serum albumin(Alb),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),hemoglobin(Hb),total lymphocyte count(TLC),and C-reactive protein(CRP)],and pulmonary function indicators[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),and the ratio of FEV1 to FVC(FEV1/FVC)]were compared between the two groups.Logistic regression analysis was used to identify independent risk factors for malnutrition in these patients.Results The incidence of malnutrition in elderly TB patients with pulmonary infection was 52.65%(119/226).The levels of TLC,Alb and Hb in eutrophia group were higher than those in malnutrition group,while levels of TC,LDL-C,CRP,FVC,FEV1 and FEV1/FVC were lower than those in malnutrition group(P<0.05).The results of Logistic regression analysis showed that too low levels of TLC,Alb and Hb,and too high levels of TC,LDL-C and CRP were independent risk factors of malnutrition(P<0.05).Conclusions Elderly patients with tuberculosis(TB)and pulmonary infection who are malnourished tend to exhibit lower levels of TLC,Alb,and Hb,as well as relatively higher levels of TC,LDL-C,and CRP.These aforementioned indicators all have an impact on the occurrence of malnutrition in these patients.
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