摘要
目的 观察全科老年住院患者营养不良临床特征,并探讨其发生的影响因素。方法 选取2019年1月至2023年1月于拉萨市人民医院住院的240例全科老年患者临床资料,统计全部入选者临床资料,将出现营养不良的患者纳入营养不良组,未出现营养不良的患者纳入营养正常组;统计营养不良组患者临床特征,并对比两组基线资料和实验室资料,采用Logistic回归分析影响全科老年住院患者发生营养不良的影响因素,绘制ROC曲线评估上述影响因素对全科老年住院患者发生营养不良的预测价值。结果 住院的240例老年患者中,发生营养不良的患者103例,占比42.92%;营养正常组137例,占比57.08%.全科老年住院患者营养不良临床特征主要有体重衰减,皮肤肌肉衰减、粗糙、松弛,口腔溃疡,毛发稀疏脱落,水肿,胃肠道不适、食欲差,视力模糊,其中体重衰减和皮肤肌肉衰减、粗糙、松弛占比最多。两组基线资料中,性别、住院时间、病程、婚姻状况以及文化水平对比无差异(P>0.05);营养不良组的年龄、糖尿病以及上臂围明显高于营养正常组,差异有统计学意义(P<0.05)。两组实验室资料对比中,血压、总胆固醇(TC)、血红蛋白(HGB)、空腹血糖(FPG)、红细胞计数(RBC)、白细胞计数(WBC)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、血尿酸(UA)、钙(Ca)以及磷(P)对比无差异(P>0.05);营养不良组的TC水平明显高于营养正常组,营养不良组的HGB水平明显低于营养正常组,差异有统计学意义(P<0.05)。经Logistic回归分析结果显示,年龄、上臂围、糖尿病、TC以及HGB是全科老年住院患者营养不良发生的影响因素(P<0.05),并绘制ROC曲线,年龄、上臂围、糖尿病、TC以及HGB的AUC值均>0.70,说明上述指标对于全科老年住院患者营养不良发生具有良好的诊断价值。结论 年龄、上臂围、糖尿病、TC以及HGB等影响因素,对全科老年住院患者营养不良发生具有较好的诊断价值,临床治疗中可依此及早识别全科老年住院患者营养不良状况。
Objective To observe the clinical characteristics of malnutrition in elderly inpatients in general practice,and to explore the corresponding influencing factors.Methods The clinical data of 240 elderly patients in our hospital from January 2019 to January 2023 were selected,and the clinical data of all the selected patients were counted.The patients with malnutrition were included in the malnutrition group,and the patients without malnutrition were included in the normal nutrition group.The clinical characteristics of patients in the malnutrition group were statistically analyzed,and the baseline data and laboratory data of the two groups were compared.The influencing factors affecting malnutrition in elderly inpatients in general practice were analyzed by logistic regression analysis,and the ROC curve was drawn to evaluate the predictive value of the above influencing factors on malnutrition in elderly inpatients in general practice.Results Among the 240 elderly patients hospitalized in our hospital,103(42.92%)were malnourished,and 137(57.08%)were in the normal nutrition group.The clinical characteristics of malnutrition in elderly inpatients in general practice mainly include weight loss,skin muscle attenuation,roughness and relaxation,oral ulcer,hair thinning and loss,edema,gastrointestinal discomfort,poor appetite and blurred vision,among which weight loss and skin muscle attenuation,roughness and relaxation account for the most.There were no differences in sex,length of hospital stay,course of illness,marital status and educational level between the two groups(P>0.05).The age,diabetes and upper arm circumference of the malnourished group were significantly higher than those of normal nutrition group,the difference of which was statistically significant(P<0.05).In the comparison of laboratory data between the two groups,there were no differences(P>0.05)in the comparisons of blood pressure,total cholesterol(TC),hemoglobin(HGB),fasting blood glucose(FPG),red blood cell count(RBC),white blood cell count(WBC),aspartate aminotransferase(AST),alanine aminotransferase(ALT),serum uric acid(UA),calcium(Ca)and phosphorus(P).The TC level in malnourished group was significantly higher than that in the normal group,and the HGB level in malnourished group was significantly lower than that in normal group,with statistical significance(P<0.05).The results of logistic regression analysis showed that age,upper arm circumference,diabetes,TC and HGB were the influencing factors of malnutrition in elderly inpatients in general practice(P<0.05).The ROC curve was drawn,and AUC values of age,upper arm circumference,diabetes,TC and HGB were all greater than 0.70,which indicated that the above indicators had good diagnostic value for malnutrition in elderly inpatients in general practice.Conclusion The influencing factors such as age,upper arm circumference,diabetes,TC and HGB have good diagnostic value for the occurrence of malnutrition in elderly inpatients,and can be used to identify malnutrition in elderly inpatients in general practice as early as possible in clinical treatment.
作者
王鸥
Wang Ou(Lhasa People's Hospital,Lasa 850000,China)
出处
《西藏科技》
2024年第1期64-70,共7页
Xizang Science And Technology
基金
拉萨市人民医院院内基金项目(SYKY2021012)。
关键词
老年住院患者
营养不良
临床特征
影响因素
Elderly inpatients
Malnutrition
Clinical characteristics
Influencing factor
