摘要
目的探讨影响急性脑卒中患者营养不良、卒中后并发症及不良预后的危险因素。方法收集122例急性脑卒中患者的一般资料,进行营养状况和神经功能缺损程度评估。3个月后采用改良Rankin量表(mRS)评估预后。分析各因素与急性脑卒中患者营养不良、卒中后并发症及不良预后的关系。结果随访结束时,共91例患者纳入本次研究。年龄及NIHSS评分为入院时营养不良的危险因素(P<0.05～0.001);年龄、高胆固醇血症、入院营养不良、鼻饲为7 d时营养不良的危险因素(P<0.05～0.001)。多因素Logistic回归分析显示,入院营养不良为7 d发生营养不良的独立预测因素(OR=14.15,95%CI:3.32～61.76,P<0.001)。年龄、入院NIHSS评分、入院营养不良、鼻饲、7 d时NIHSS评分、7 d时营养不良及营养状况恶化为发生并发症的危险因素(均P<0.01)。多因素Logistic回归分析显示,入院NIHSS评分及入院营养不良为并发症的独立预测因素(OR=1.11,95%CI:1.04～1.48,P<0.05;OR=6.56,95%CI:1.18～42.72,P<0.05)。年龄、入院NIHSS评分、7 d时NIHSS评分、7 d时营养不良及营养状况恶化为预后不良的危险因素(P<0.05～0.01)。多因素Logistic回归分析显示,7 d时营养不良及7 d时NIHSS评分为预后不良的独立预测因素(OR=4.32,95%CI:1.15～18.89,P<0.05;OR=1.81,95%CI:1.21～2.43,P<0.01)。结论入院营养不良为7 d发生营养不良的独立危险因素,入院NIHSS评分及营养不良为并发症的独立危险因素,7 d时营养不良及NIHSS评分为预后不良的独立危险因素。
Objective To investigate the risk factors of undernutrition, complications and poor prognosis in acute stroke patients. Methods The general information of 122 acut stroke patients were collected. The undernutritional status and nerve function defect degree were evaluated. The prognosis was evaluated by modified Rankin scale （mRS） after 3 months. The factors related to undernutrition, complications and poor prognosis were analyzed. Results Ninety-one patients were included in this study at follow-up. Age and NIHSS score were risk factors of undernutrition at admission （P 〈 0.05 -0. 001 ）. Age, hypercholesterolemia, undernutrition at admission and enteral feed were risk factors of undernutrition at 7 d （ P 〈 0.05 - 0. 001 ）. Multiple logistic regression analysis showed that undernutrition at admission was the independent predictors of undernutrition at 7 d （ OR = 14.15, 95% CI： 3.32 - 61.76, P 〈 0. 001 ）. Age, NIHSS score at admission, undernutrition at admission, enteral feed, NIHSS score at 7 d, undernutrition and nutritional worsened at 7 d were risk factors of complications （all P〈 0. 01 ）. Multiple logistic regression analysis showed that NIHSS score and undernutrition at admission were the independent predictors of complications （ OR = 1.11,95% CI： 1.04 - 1.48, P 〈 0. 05 ; OR = 6.56, 95% CI： 1.18 - 42.72, P 〈 0. 05 ）. Age, NIHSS score at admission, NIHSS score at 7 d, undernutrition and nutritional worsened at 7 d were risk factors of poor prognosis （ P 〈 0. 05 - 0.01 ）. Multiple logistic regression analysis showed that undernutrition and NIHSS score at 7 d were the independent predictors of poor prognosis （OR = 4.32, 95% CI： 1. 15 -18.89, P 〈 0. 05 ; OR = 1.81, 95% CI： 1.21 - 2.43, P 〈 0. 01 ）. Conclusions Undernutrition at admission is the independent predictors of undernutrition at 7 d. NIHSS score and undernutrition at admission are the independent predictors of complications. Undernutrition and NIHSS score at 7 d are the independent predictors of poor prognosis.
出处
《临床神经病学杂志》
CAS
北大核心
2013年第1期31-34,共4页
Journal of Clinical Neurology
基金
广西壮族自治区卫生厅课题(Z2008442
Z2010009
Z2012612)
关键词
急性脑卒中
营养不良
并发症
不良预后
undernutrition
older patients
acute stroke
complications
poor prognosis
