CAJ | 학술논문

目的分析老年住院患者营养不良的危险因素,为预防及治疗提供依据.方法采用1∶1配对病例对照试验方法,调查2所三甲医院住院老年患者营养不良的影响因素.结果共纳入研究对象85对,单因素分析显示血清总蛋白、血红蛋白、血清总胆固醇、非自主选择食物、厌食、吞咽困难、卧床及急慢性感染可能是住院老年患者营养不良的影响因素(均P＜0.05),Logistic回归显示血清总蛋白、血红蛋白、厌食、吞咽困难和卧床可能是住院老年患者的主要危险影响因素(P＜0.05),以上述危险因素对营养不良患者进行预测,预测结果与实际结果符合良好(x2=4.957,P=0.762),ROC曲线显示总蛋白及血红蛋白曲线下面积分别为0.760(P=0.000)和0.621(P=0.006),两者界点分别为56.8 g/L和108 g/L时可能有一定参考意义.结论厌食、吞咽困难及卧床可能是住院老年患者营养不良的危险因素,较高的总蛋白及血红蛋白则可能是保护性因素,对这些因素的纠正或保护,可能改善住院老年患者的营养不良状况.
목적 분석노년주원환자영양불량적위험인소,위예방급치료제공의거.방법 채용1∶1배대병례대조시험방법,조사2소삼갑의원주원노년환자영양불량적영향인소.결과 공납입연구대상85대,단인소분석현시혈청총단백、혈홍단백、혈청총담고순、비자주선택식물、염식、탄인곤난、와상급급만성감염가능시주원노년환자영양불량적영향인소(균P＜0.05),Logistic회귀현시혈청총단백、혈홍단백、염식、탄인곤난화와상가능시주원노년환자적주요위험영향인소(P＜0.05),이상술위험인소대영양불량환자진행예측,예측결과여실제결과부합량호(x2=4.957,P=0.762),ROC곡선현시총단백급혈홍단백곡선하면적분별위0.760(P=0.000)화0.621(P=0.006),량자계점분별위56.8 g/L화108 g/L시가능유일정삼고의의.결론 염식、탄인곤난급와상가능시주원노년환자영양불량적위험인소,교고적총단백급혈홍단백칙가능시보호성인소,대저사인소적규정혹보호,가능개선주원노년환자적영양불량상황.
Objective To investigate the risk factors associated to malnutrition in elderly inpatients for supplying clinical evidences for the prevention and therapy of malnutrition. Methods A one-to-one matched case-control study was used to investigate the risk factors associated to malnutrition in elderly inpatients over 60 years old. Results Eight-five pairs were included. Single factor analysis suggested that serum total protein. hemoglobin, serum total cholesterol, non auto -selective food, anorexia, dysphasia, confinement in the bed and infectious diseases might be associated with malnutrition in elderly inpaticnts (all P＜ 0.05 ). Logistic regression analysis demonstrated that serum total protein, hemoglobin, anorexia, dysphasia and confinement in the bed were the major risk factors (P＜0.05). Hosmer-Lemeshow test showed the predicable results and practical results had better similarity (x2 =4. 957, P= 0. 762). Receiver operation characteristic curve ( ROC curve) also revealed the area under curve of serum total protein and hemoglobin were 0 760 and 0.621(P=0.000 and P=0.006 respectiuely), therefore, 56.8 g/L of serum total protein and 108 g/L of hemoglobin might be appropriate reference points for evaluating the malnutrition. Conclusions Serum total protein, hemoglobin, anorexia, dysphasia and confinement in the bed may play crucial roles for malnutrition in elderly inpatients, the status of malnutrition will be improved if the reversible risk factors are amendable.