| 引用本文： |
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陈胜芳,吴萍,申颖,等.老年住院患者营养状况与日常生活能力的关系[J].同济大学学报（医学版）,2013,34(6):102-106. [点击复制]
- CHEN Sheng-fang,WU Ping,SHEN Ying,et al.Relationship between nutritional status and activities of daily living in elderly inpatients[J].同济大学学报（医学版）,2013,34(6):102-106. [点击复制]
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| 摘要: |
| 目的研究老年住院患者的营养特点，以及营养状况对老年患者日常生活能力（activities of daily living,ADL）的影响。方法符合观察条件的老年患者215例，采用Barthel指数（BI）评定量表评估日常生活能力，测定血常规、血浆蛋白、血脂及肝肾功能指标，并进行人体测量和简易营养状态评估。结果（1）本组老年患者贫血发生率为35．3％（76／215），低蛋白血症发生率为42．8％（92／215），其中16．3％（15／92）的患者为重度低蛋白血症：基于简易营养状态评估短表（the mini assessment short form, MNA-SF）评分，营养不良发生率为5．1％，37．2％（80／215）的患者存在营养不良风险。（2）BI评定显示，16．3％（35／215）的患者存在中、重度ADL依赖，且以脑卒中患者为主（77．1％）；校正年龄、性别、合并症后，偏相关分析显示，MNA—SF评分、握力（GS）、上臂围（AC）、小腿围（CC）、血清白蛋白（ALB）、前白蛋白（PA）、总胆固醇（TC）与ADL呈正相关（P=0．000；P=0．000；P=0．018;P=0．000；P=0．025；P=0．023；P=0．030），相关有统计学意义。（3）逐步多元回归分析显示，MNA—SF评分、GS、ALB水平是影响ADL的决定因素，R^2=0．259（β=0．286，P=0．000，β=0．206，P=0．005；β=0．215，P=0．003）。结论老年住院患者ADL依赖以脑卒中为主，以低蛋白血症为主的营养不良、肌力减退是影响ADL的主要因素。 |
| 关键词: 老年人 营养状况 日常生活能力 MNA—SF评分 低蛋白血症 |
| DOI：10. 3969/j. issn1008-0392. 2013. 06. 023 |
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| 基金项目: |
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| Relationship between nutritional status and activities of daily living in elderly inpatients |
| CHEN Sheng-fang,WU Ping,SHEN Ying,YAO Yun,CUI Chun-li |
| (Dept. of Clinical Nutrition, Tongji Hospital, Tongji University, Shanghai 200065, China;Dept. of Nephrology, Tongji Hospital, Tongji University, Shanghai 200065, China) |
| Abstract: |
| Objective To investigate the relationship of nutritional status and activities of daily living in elderly inpatients. Methods Two hundred and fifteen elderly patients were included in the study. The activities of daily living （ADL） were evaluated with Barthel index （BI）. Fasting blood samples were collected, the liver and kidney function, blood routine, plasma protein, lipid profile were measured. Anthropometric measurements, grip strength and the MNA short form （MNA-SF） were used to assess the nutritional status. Results In these subjects, the prevalence of anemia and hypoalbuminemia was 35.3% （76/215） and 42.8% （92/215） respectively, in which 16.3% （ 15/92） was severe hypoalbuminemia. Based on MNA-SF scores, 5. 1% （11/215） patients were malnourished and 37.2% （80/215） were at risk of malnutrition. 16.3% （35/215） of patients were moderate or severe dependent in performance of ADL and most of them （77. 1% ） suffered strokes. After adjusting age, gender and complications, the partial correlation analysis indicated that MNA-SF scores, grip strength （GS）, mid-arm circumference （AC）, calf circumference （CC）, serum albumin （ALB）, prealbumin （PA） and total cholesterol （TC） were positively correlated with ADL （P = 0.000; P =0.000; P =0.018; P =0.000; P =0.025; P =0.023; P =0.030）. Multivariate regression analysis showed MNA-SF scores, GS and ALB were independent determinants of ADL in elderly inpatients, and R2 =0. 259 （β =0.286, P =0. 000;β =0. 206, P =0. 005; β =0. 215, P = 0. 003 ）. Conclusion Dependence in performance of ADL mainly existed in the elderly patients with stroke. Hypoalbuminemia and decreased muscle strength are the main factors influencing the ADL of elderly patients. |
| Key words: elderly nutritional status activities of daily living MNA-SF score hypoalbuminemia |
