慢性阻塞性肺疾病患者营养状况及其病情分级危险因素分析
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本科,护师,主要研究方向:感染性疾病的防治

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R181

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Nutritional status and risk factors of disease condition grading in patients with chronic obstructive pulmonary disease
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    摘要:

    目的 分析慢性阻塞性肺疾病(chronic obstructive pulmonary disease , COPD)患者营养状况及其病情分级危险因素,为临床诊疗提供参考。方法 选取2020年2月至2023年2月医院收治的518例COPD患者作为研究对象(COPD组)。选择同期呼吸与危重症医学科病房520例非COPD患者作为对照组。将COPD患者按营养状况分为营养不良组265例和营养正常组253例,观察不同病情分级患者的营养状况,对比两组基本情况和临床检查情况,并采用多因素logistic回归分析探讨COPD患者营养不良的危险因素。 结果 COPD组营养指标BMI、IBM、ALB比对照组低(P<0.05);COPD病情分级越高营养指标水平越低(P<0.05);营养不良组吸烟史、急性加重次数≥2次/年、合并疾病种类≥4种、ALB<35 g/L、CRP≥60 mg/L、CAT评分≥10分、FEV1/FVC<50%占比高于营养正常组,使用呼吸机占比低于营养正常组(P<0.05);logistic回归多因素分析显示,急性加重次数≥2次/年、合并疾病种类≥4种、CRP≥60 mg/L、FEV1/FVC<50%均为影响COPD患者营养不良的独立危险因素,使用呼吸机为保护因素(P<0.05)。结论:COPD患者营养状况不佳,且病情分级越严重,营养状况越差,急性加重次数、合并疾病种类、CRP、FEV1/FVC均为COPD患者发生营养不良的影响因素。

    Abstract:

    Objective To analyze the nutritional status and risk factors of disease condition grading in patients with chronic obstructive pulmonary disease (COPD), and to provide the reference for clinical diagnosis and treatment.. Methods A total of 518 patients with COPD who were admitted to the hospital from February 2020 to February 2023 were selected as the study subjects (COPD group). Among the 520 cases of non-COPD patients in respiratory and critical care wards were included in control group . The patients with COPD were divided into 265 cases in malnutrition group and 253 cases in normal nutrition group according to the nutritional status. The nutritional status of patients with different disease condition grades was observed . The basic information and clinical examination status were compared between both groups, and multivariate logistic regression analysis was used to explore the risk factors of malnutrition in patients with COPD. Results The nutritional indicators of BMI, IBM and ALB in COPD group were lower than those in control group (P<0.05). The higher the disease condition grade , the lower the levels of nutritional indicators (P<0.05). The proportions of smoking history, number of acute exacerbations ≥twice a year, comorbidity types≥4, ALB<35 g/L, CRP≥60 mg/L, CAT score≥10 points and FEV1/FVC<50% in malnutrition group were higher than those in normal nutrition group while the proportion of ventilator use was lower than that in normal nutrition group (P<0.05) . Multivariate Logistic regression analysis showed that the number of acute exacerbations≥ twice a year, comorbidity types≥4, CRP≥60 mg/L and FEV1/FVC<50% were independent risk factors of malnutrition in patients with COPD, and ventilator use was a protective factor (P<0.05). Conclusion The nutritional status of COPD patients is poor , and the more serious the disease condition grade , the worse the nutritional status . The number of acute exacerbations , types of concurrent diseases , CRP , FEV1/FVC are all influencing factors of malnutrition in COPD patients.

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  • 收稿日期:2024-12-05
  • 最后修改日期:2024-12-05
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  • 在线发布日期: 2025-01-15
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