老年烧伤患者的营养状态评价

目的分析反映老年烧伤患者营养状态的指标的变化规律，以指导营养支持治疗。方法以2004年1月-2007年10月入院的83例年龄超过60岁的轻度烧伤老年患者作为研究对象，以同期人院的20例中青年烧伤患者作对照。将不同性别的老年患者按年龄分别分为60—69岁、70—79岁、≥80岁组，共6组。于入院次日晨起抽取患者空腹静脉血，检测血清总蛋白、白蛋白、前白蛋白、胆碱酯酶、血红蛋白水平，淋巴细胞数、淋巴细胞百分比，并将各指标与年龄进行相关性分析，统计患者营养不良的发生率。结果与中青年烧伤患者比较，各年龄段老年烧伤患者的血清总蛋白、白蛋白、前白蛋白、胆碱酯酶水平、淋巴细胞数、淋巴细胞百分比均不同程度下降，且与年龄呈显著负相关。老年烧伤患者营养不良的总发生率为28．9％，各年龄组营养不良发生率的差异具有显著性（P=0．002），≥80岁组最高（72．7％），60—69岁组最低（18．8％）。老年女性营养不良发生率（40．4％）显著高于男性（13．9％，P=0．000）。结论营养不良在老年烧伤患者中较普遍，年龄越大发生率越高，特别是老年女性，应根据老年烧伤患者营养不良的发生特点采取适当的营养支持措施。

Evaluation of Nutritional Status of Elderly Burn Patients

Objective To analyze the alteration of nutritional status in elderly burn patients. Methods Eighty-three elderly burn inpatients （ 〉 60 years） who were enrolled from January 2004 to October 2007 were divided into 6 groups according to age and gender： 60-69-year-old groups, 70-79-year-old groups, and ≥ 80-year-old groups. Twenty cases of young and middle-aged burn inpatients during the same period were enrolled as the control group. Venous blood samples were collected the next day after their admission to measure the levels of serum total protein （TP）, albumin （ ALB ）, prealbumin （ PreA）, cholinesterase （ CHE ）, and hemoglobin, lymphocyte count （Lym）, and lymphocyte percentage （Lym%）. The correlation between these parameters and age were analyzed. The malnutrition rate was calculated. Results Compared with the young and middleaged burn patients, the serum levels of TP, ALB, PreA, and CHE, Lym, and Lym% in the elderly patients in different age groups decreased to different extents, and these parameters were negatively correlated with age. The malnutrition rate was 28.9% among all the elderly patients, and significant differences existed among the groups （P =0. 002）. The highest malnutrition rate was noted in the ≥80-year-old group （72.7%） and the lowest malnutrition rate was in the 60-69-year-old group （ 18.8 % ）. The malnutrition rate was significantly higher in women than in men （40.4 % vs. 13.9 % , P = 0. 000 ）. Conclusions Malnutrition was common in the elderly burn patients, especially in women. The incidence of malnutrition increased with aging. Nutrition support should be provided based on the malnutrition status in the elderly burn patients.