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存在营养风险呼吸系统疾病患者不同启动时间营养干预效果比较

Comparison of nutritional intervention effects at different initiation time in patients with respiratory diseases at nutritional risk

  • 摘要:
    目的 评估尽早营养干预对存在营养风险呼吸系统疾病患者的效果。
    方法 选择2023年5月至2024年12月在复旦大学附属上海市第五人民医院住院且营养风险筛查2002评分≥3分的130例患者。根据营养干预的启动时间,将患者分为早期组(营养干预启动≤5 d,n=65)和晚期组(营养干预启动>5 d,n=65)。
    结果 早期组干预后,患者前白蛋白(P-ALB)和视黄醇结合蛋白(RBP)水平升高(P<0.01),C反应蛋白(CRP)、降钙素原(PCT)水平降低(P<0.05)。与晚期组相比,早期组患者住院费用减少、住院时间缩短(P<0.001)。Spearman分析显示,ALB、P-ALB 、血清总蛋白(TP)与住院费用负相关(r=-0.37、-0.20、-0.22,P<0.05);RBP、ALB、P-ALB、淋巴细胞计数(LYM)与CRP负相关(r =-0.30、-0.26、-0.37、-0.18,P<0.01),RBP、ALB、P-ALB、血红蛋白(HB)、TP与PCT负相关(r=-0.23、-0.36、-0.40、-0.30、-0.19,P<0.05)。
    结论 尽早对呼吸系统疾病患者进行营养评估,对其中营养风险筛查2002评分≥3分者尽早干预,有助于改善其营养状况和降低炎症水平,促进康复,减少住院费用。

     

    Abstract:
    Objective To assess the effect of early nutritional intervention on the patients with respiratory diseases at nutritional risk.
    Methods A total of 130 patients with respiratory disease who were hospitalized in Shanghai Fifth People’s Hospital, Fudan University between May 2023 and December 2024 and had a nutritional risk screening 2002 score ≥3 points. Based on the initiation time of nutritional intervention, patients were divided into an early group (≤5 days, n=65) and a late group (>5 days, n=65).
    Results In the early group, prealbumin (P-ALB) and retinol-binding protein (RBP) levels were significantly higher (P<0.01), C-reactive protein (CRP), procalcitonin (PCT) levels were significantly lower after intervention (P<0.05). Compared with the late group, the hospital costs were lower and hospital stays were shorter in the early group (P<0.001). Spearman analysis showed ALB, P-ALB, and total protein (TP) were negatively correlated with hospital costs (r=-0.37, -0.20, and-0.22, P<0.05). RBP, ALB, P-ALB, and lymphocyte count (LYM) were negatively correlated with CRP (r=-0.30, -0.26, -0.37, -0.18, P<0.01), RBP, ALB, P-ALB, hemoglobin (HB), and TP were negatively correlated with PCT (r=-0.23,-0.36, -0.40, -0.30, -0.19, P<0.05).
    Conclusions For patients with respiratory diseases, early nutritional assessment should be underwent, and for patients with nutritional risk screening 2002 score ≥3 points, early nutritional intervention could improve the nutritional status and alleviate inflammatory response, promote recovery, shorten the hospital stays.

     

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