中国卒中住院患者早期营养状态的变化

doi:10.3969/j.issn.1673-5765.2021.05.013

摘要/Abstract

摘要：

目的用不同营养指标评估卒中住院患者早期营养状态的变化。方法多中心连续收集发病7 d内的首次缺血性卒中和脑出血患者。在入院时利用BMI、上臂中部周径（mi d-upper arm circumference，MUAC）、肱三头肌皮褶厚度（triceps skinfold thickness，TSF）、血清白蛋白和前白蛋白水平评估患者营养状态，入院14 d时重复营养状态的评估，观察14 d内患者营养状态的变化。结果研究共入组760例卒中患者。入院14 d的BM（I 24.3±3.5 kg/m2 vs 24.7±3.6 kg/m2）、MUAC （28.3±13.5 cm vs 28.8±3.3 cm）、TSF（17.0±7.4 mm vs 17.9±7.6 mm）、血清白蛋白水平（39.3±4.7 g/L vs 40.6±4.3 g/L）较入院时均显著降低（均P＜0.0001）。分析各指标的异常率，入院14 d时低 BMI（4.0% vs 2.9%，P =0.0455）、MUAC（9.7% vs 6.8%，P =0.0004）、TSF（11.8% vs 10.0%，P =0.0164）、血清白蛋白（9.2% vs 6.2%，P＜0.0001）和前白蛋白（17.6% vs 12.1%，P＜0.0001）的比例均显著高于入院时。结论卒中患者早期营养状态呈恶化趋势，不同指标所检出的营养不良率差别较大，应强调早期利用多项指标观察卒中患者营养状态的重要性。

文章导读： 本研究通过多中心、前瞻性调查分析显示，住院卒中患者发病后早期（14 d）的营养状态较入院时明显下降，不同营养指标显示的营养不良率也有差异，因此建议临床应结合多项指标判断患者的营养状态。

关键词: 卒中; 营养状态; 营养恶化

Abstract:

Objective To evaluate the changes in the early nutritional status in Chinese stroke inpatients by different nutrition parameters. Methods Patients with ischemic stroke or cerebral hemorrhage within 7 days after stroke onset were consecutively admitted in multiple medical centers. Nutritional status at admission was assessed by using BMI, mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF), serum albumin and prealbumin. The above nutritional parameters were assessed again after 14 days. The changes in nutritional status of the stroke patients within 14 days were analyzed. Results A total of 760 stroke patients were included. BMI (24.3±3.5 kg/m2 vs 24.7±3.6 kg/m2), MUAC (28.3±13.5 cm vs 28.8 ±3.3 cm), TSF (17.0±7.4 mm vs 17.9±7.6 mm), serum albumin (39.3±4.7 g/L vs 40.6±4.3 g/L) at 14 days after admission were significantly lower than those at admission (all P <0.0001). The proportion of low BMI (4.0% vs 2.9%, P =0.0455), MUAC (9.7% vs 6.8%, P =0.0004), TSF (11.8% vs 10.0%, P =0.0164), serum albumin (9.2% vs 6.2%, P <0.0001) and prealbumin (17.6% vs 12.1%, P <0.0001) at 14 days after admission were higher than those at admission. Conclusions The early nutritional status of stroke patients tended to deteriorate, and the malnutrition rate detected by different nutritional parameters varied widely. It should be emphasized that nutritional status after stroke onset was assessed by different nutrition parameters.

Key words: Stroke; Nutritional status; Nutrition deterioration

秦海强，王安心，左颖婷，张亚清，杨波，于丹丹，魏娜，张婧. 中国卒中住院患者早期营养状态的变化[J]. 中国卒中杂志, 2021, 16(05): 492-496.

QIN Hai-Qiang, WANG An-Xin, ZUO Ying-Ting,ZHANG Ya-Qing, YANG Bo, YU Dan-Dan, WEI Na, ZHANG Jing. Changes in Early Nutritional Status in Chinese Stroke Inpatients[J]. Chinese Journal of Stroke, 2021, 16(05): 492-496.

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