论文部分内容阅读
目的探讨老年社区获得性肺炎合并营养不良患者的临床特点及营养不良的危险因素,及时发现及纠正营养不良,改善老年社区获得性肺炎患者的预后。方法采用微型营养评估量表对118例老年社区获得性肺炎患者进行评估,按照评分结果,分为营养不良组及非营养不良组。分析两组年龄、各项临床化验指标、基础病、认知功能、焦虑抑郁状态、生活自理能力、全身炎症反应综合征(SIRS)发生率及住院天数情况。并应用Logistic回归方法分析老年社区获得性肺炎患者的危险因素。结果老年社区获得性肺炎患者营养不良发生率为30.51%。营养不良组患者的年龄(82.11±4.62岁)高于非营养不良组(76.76±5.38岁),差异有统计学意义(t=5.186,P<0.001),发热及纳差发生率高,白蛋白、血红蛋白、低密度脂蛋白及氧分压均低于非营养不良组(均P<0.05)。营养不良组中慢性心衰、慢性肾功能不全、肿瘤患病率明显高于非营养不良组(P分别为<0.001、0.044及0.003)。营养不良组认知功能及日常生活能力明显下降(P=0.030、0.007)。营养不良组患者基础病多(P=0.036),全身炎症反应综合征的发生率明显增高(P=0.040),住院天数明显延长(P<0.001)。采用Logistic回归分析,年龄、发热、慢性心衰及重度日常生活功能障碍为高危因素。结论老年社区获得性肺炎患者营养不良发生率高,微型营养评估法可以有效地进行营养评估。老年社区获得性肺炎患者的营养不良与年龄、基础病多、发热、纳差、低氧血症、认知功能障碍、日常生活功能障碍、慢性心衰、慢性肾功能不全、肿瘤相关,其中年龄、发热、慢性心衰及重度日常生活功能障碍为高危因素。
Objective To explore the clinical features and malnutrition risk factors of elderly patients with community-acquired pneumonia complicated with malnutrition, find out and correct malnutrition in time, and improve the prognosis of elderly patients with community-acquired pneumonia. Methods One hundred and eighteen elderly patients with community-acquired pneumonia were evaluated using the mini-nutritional assessment scale. According to the scores, malnutrition and non-malnutrition groups were divided into two groups. Two groups of age, various clinical laboratory indexes, basic diseases, cognitive function, anxiety and depression status, life self-care ability, incidence of systemic inflammatory response syndrome (SIRS) and days of hospitalization were analyzed. Logistic regression analysis was used to analyze the risk factors of elderly community-acquired pneumonia. Results The incidence of malnutrition in elderly community-acquired pneumonia patients was 30.51%. The malnutrition group had higher age (82.11 ± 4.62 years) than non-malnutrition group (76.76 ± 5.38 years), the difference was statistically significant (t = 5.186, P <0.001) , Hemoglobin, low density lipoprotein and oxygen partial pressure were lower than non-malnourished group (all P <0.05). Malnutrition group chronic heart failure, chronic renal insufficiency, tumor prevalence was significantly higher than non-malnourished (P <0.001,0.044 and 0.003 respectively). Malnutrition group cognitive function and daily living ability decreased significantly (P = 0.030,0.007). Malnourished patients had more underlying diseases (P = 0.036), the incidence of systemic inflammatory response syndrome was significantly higher (P = 0.040), hospital stay was significantly longer (P <0.001). Logistic regression analysis showed that age, fever, chronic heart failure and severe daily dysfunction were risk factors. Conclusion The incidence of malnutrition in elderly patients with community-acquired pneumonia is high, and the micro-nutrition assessment can effectively evaluate nutrition. Malnutrition in elderly patients with community-acquired pneumonia is associated with age, underlying disease, fever, anorexia, hypoxemia, cognitive dysfunction, dysfunction of daily living, chronic heart failure, chronic renal insufficiency, and cancer, with age , Fever, chronic heart failure and severe dysfunction of daily life are risk factors.