维持性血液透析病人的营养状况

目的 :评价维持性血液透析 (MHD)病人的营养状况。　方法 :对 4 6例MHD病人进行膳食调查、人体测量及生化指标包括体重、肱三头肌皮皱厚度 (TSF)、上臂肌围 (AMC)、血清总蛋白 (TP)、白蛋白 (Alb)、前白蛋白 (PA)、转铁蛋白 (TF)检测 ,计算实际体重占理想体重百分比 (IBW % ) ,并作营养评价。　结果 :①MHD病人能量摄入普遍低于 12 5 .4kJ/ (kg·d) ,蛋白质摄入基本达到 1.0g/ (kg·d) ;②不同指标评估营养不良的发生率分别为IBW 9.13% ,TSF 71.74 % ,AMC 5 8.70 % ,Alb 30 .4 3% ,TF 82 .6 1%。各项指标均属正常者仅占 6 .5 2 %。　结论 :综合指标评价结果表明 ,本组病人有 93.4 8%存在不同表现和不同程度的营养不良。MHD病人进行常规的营养评价及合理的营养指导对预后有积极意义     

维持性血液透析病人的营养状况评价

目的:应用主观全面评定法(SGA)对维持性血液透析(MHD)病人的营养状况进行评价.方法:采用SGA结合有关生化指标,人体测量指标和饮食评估,对127例MHD病人的营养状况进行综合评价.结果:127例病人中营养良好者75例,轻中度营养不良39例,重度营养不良13例,总营养不良发生率为40.9%.各营养状况组之间血清ALB、PA、肌酐、肱三头肌皮皱厚度、饮食蛋白摄入量和蛋白质分解率差异显著,而三组间Kt/V无显著差异.结论:血液透析病人营养不良的发生率较高,与蛋白质摄入不足、炎症、血液透析过程本身等因素有关.     

Nutritional status of preoperative colorectal cancer patients

Background: The present study aimed to determine the extent of malnutrition in preoperative colorectal cancer patients. Malnutrition has been shown to affect post‐operative outcome, so it would be beneficial to identify those who are malnourished or who are at risk of becoming so preoperatively. We examine whether weight loss is related to the length of stay or changes in fat free mass. Methods: Patients were enrolled consecutively from outpatients 2–4 weeks prior to surgery. Assessments included body mass index, percentage weight loss, dynamometry, Malnutrition Universal Screening Tool, Subjective Global Assessment and bioelectrical impedance. Cancer staging and hospital length of stay were recorded. Results: One hundred and thirty‐two patients were eligible and 87 enrolled. Sixty‐seven patients were weight losing and 20% had lost >10% of their usual body weight. Handgrip strength was lower in malnourished patients compared to those who had not lost weight (mean 19.4 and 27.3 kg, respectively, P = 0.013). Mean (SD) fat free mass in patients with a weight loss >10% was 39.7 (13.5) kg and, in those with <10% weight loss, was 51.9 (12.0) kg (P = 0.001). This difference was not demonstrated for fat. Conclusions: Over half of these patients had lost weight prior to surgery and one in five were malnourished. Body composition measurements demonstrated that malnourished patients had significantly less fat free mass compared to patients who were not clinically malnourished. Nutritional screening would be beneficial in this group preoperatively to identify weight‐losing patients at an early stage in the care pathway when they initially enter the secondary care system.     

Nutritional status and clinical outcomes of older patients in rehabilitation

BACKGROUND: Malnutrition is associated with poor outcomes in older adults and those admitted to rehabilitation may be particularly at risk. Objective To assess the nutritional status and outcomes of older adults in rehabilitation. SUBJECTS AND METHODS: We recruited 133 adults > or = 65 years from consecutive rehabilitation admissions. Nutritional status was assessed using the mini nutritional assessment, body mass index (BMI) and corrected arm muscle area (CAMA). Outcomes measured included length of stay, admission to higher level care, function and quality of life (QOL). RESULTS: Sixty-two (47%) subjects were well nourished, 63 (47%) at risk of malnutrition and eight (6%) malnourished. Twenty-two (17%) and 27 (20%) were below the desirable reference values for BMI and CAMA respectively. Subjects at risk of malnutrition/malnourished had longer length of stay (P = 0.023) and were more likely to be admitted to higher level care (P < 0.05). These subjects also had poorer function on admission (P < 0.001) and 90 days (P = 0.002) and QOL on admission (P < 0.008) and 90 days (P = 0.001). Those with low CAMA were twice as likely to be admitted to higher level care (P < 0.05) and had poorer function at 90 days (P = 0.017). CONCLUSIONS: Over half our sample was identified as at risk of malnutrition or malnourished and this was associated with poorer clinical outcomes.     

Nutritional status in alcoholism

An intensive study of 39 alcoholic patients with liver disease indicated a wide range of nutritional status; severe malnutrition was uncommon.
Normal values for all measurements of anthropometry and vitamin status were observed in 41 and 13% of 39 subjects respectively. Mild protein-energy malnutrition (by anthropometry) was observed in 22%. The incidence of abnormal biochemical levels of the micronutrients were: riboflavin (69%), magnesium (54%), zinc (50%). thiamin (44%), pyridoxine (21%), ascorbate (19%), and folate (18%).     

Nutritional awareness of mothers in relation to nutritional status of the preschool children

Background: In the developing world, nearly one-third (35%) of under-five children are stunted and rural children are twice likely to be underweight as those in urban areas (United Nations, Children education Fund, UNICEF Global Database. (2006–2010). United Nations Development Assistance Framework of Uganda. Retrieved from https://countryoffice.unfpa.org/uganda/drive/Uganda_UNDAF.pdf). India presents a grim scenario which lacks in various aspects inflicting sufferings on children below five years of age. The objective of the study is to find out the association between mother's nutritional awareness and nutritional status of the child (NSC). Methodology: The sample consisted of 300 children of 3–4 years of age from kindergarten and preprimary schools of Kolkata. The tools used were Nutritional Awareness of Mother (NAM) questionnaire and NSC by measuring age, height and weight of children which were used for finding weight for age, height for age and weight for height of the child and the statistical analysis used was chi-square test. Results: The result showed that nutritional awareness of mother significantly influences the NSC. Conclusions: The study would help in motivating educators for incorporating need-based educative measures for young adolescents and thus the eradication of various issues regarding infant mortality rate, maternal mortality rate, etc. may be checked to some extent.     

血液透析患者膳食状况的评价

目的利用理想膳食模式评分法评价维持性血液透析患者的膳食质量。方法选取2012年10月—2013年2月在无锡市某三甲医院血液透析中心透析的79例患者,进行膳食情况及个人基本情况调查,采用理想膳食模式（desirable diet-ary pattern,DDP）评分及评价方法评价维持性血液透析人群的膳食质量。结果79例维持性血透患者的DDP分值为79．8分,动物性食物和食用油的摄入量超过了最大允许值（动物性食物58。s50,食用油10vs10）。从食物类别的分类看,谷类、蔬菜类及水果类的DDP得分均低于理想得分（谷类28vs40,蔬菜水果类5vs10）。按透析年数、透析频次、体重控制情况、知晓饮食情况及饮食控制程度不同比较,食用油摄入量差异均有统计学意义（P〈0．05）,余均无统计学意义。结论经理想膳食模式评分法评价,维持性血液透析患者膳食质量存在结构不均衡及总能量摄入不足的问题。     

不同HCO3^-浓度透析液对透析患者酸碱平衡和营养状态的影响

目的旨在分析不同HCO3^-浓度透析液对机体酸碱平衡以及营养状态的影响。方法24例稳定的维持性血液透析患者参与试验，使用单盲、交叉对照分析，共3个月试验周期，参试患者分别接受低HCO3^-浓度透析液（30．0mmol／L）（甲组）和高HCO3^-浓度透析液（40．0mmol/L）（乙组）透析，记录并分析人体生物学指标、生化指标和透析剂量以及透析充分性指标。结果试验开始时甲、乙组血清总CO2结合力分别为（22．0±2．6）mmol/L、（22．54±-3．2）mmol／L，两组比较差异无统计学意义；但乙组3个月后血清总CO2结合力增高到（25．5±1．8）mmol/L，与试验开始时比较差异有统计学意义；甲组无显著性变化。Kt／V（乙组1．29±0．21、甲组1．28±0．15），标准化蛋白代谢率（nPCR）[乙组（1．15±0．16）g／（kg·d）、甲组（1．25±0．18）g／（kg·d）]差异均无统计学意义。三角肌皮褶厚度（TSF）有显著性变化[甲组由试验开始时（14．8±1．6）mm，至3个月后（12．6±1．1）mm，乙组为（14．5±2．3）至（16．5±1．5）mm，P〈0．0530结论高HCO3^-浓度透析液对透析患者是相对安全的，患者均能较好耐受，且能较好地纠正机体酸中毒状态，与低HCO3^-浓度透析液相比，能提高患者TSF，提示患者营养状态改善。     

健康教育对血液透析患者疾病认知水平及营养状况的影响

目的探讨健康教育对血液透析患者疾病认知水平及营养状况的影响。方法按照随机数字法将180例血液透析患者随机分为干预组和对照组,每组90例,对照组给予常规治疗,干预组在对照组基础上实施健康教育,干预6个月后对患者进行疾病认知水平和营养状况的效果评价。结果干预前,2组患者疾病相关知识的知晓情况、营养评价指标差异均无统计学意义（P〉0.05）。干预后,干预组患者对血液透析注意事项（81.1%）、并发症预防（78.8%）、合理用药（83.3%）、营养饮食（82.2%）、内瘘的防护（77.8%）、健康心理的重要性（87.8%）、定期复检的重要性（86.7%）等知识知晓率均高于对照组和自身干预前（P〈0.01）。干预组患者的SGA评分（23.08±1.24）,人体测量学指标BMI（21.49±1.35）、TSF（13.73±1.72）、AC（24.46±1.19）,AMC（23.42±1.64）,血液生化指标TP（57.97±3.47）、AIB（38.75±2.86）、HB（97.49±3.65）等指标均高于自身干预前及对照组（P〈0.01）。结论健康教育能有效提高血液透析患者的疾病认知水平、改善患者的营养状况。     

湖北省老年住院患者营养状况调查及评价

目的 评估湖北省老年住院患者营养状况及其影响因素,为老年住院患者合理营养支持提供依据。方法 采取分层随机抽样方法,对2014年5—12月湖北省黄冈市等5个地区住院治疗的4 946例老年患者进行营养状况评估。结果 城市和农村居民肥胖率分别34.16%和15.44%,差异有统计学意义(χ²=30.47,P<0.05);营养风险筛查(NRS)评分中,老年住院患者营养风险发生率、贫血发生率、血清总蛋白(TP)异常发生率、血清白蛋白(ALB)异常发生率、总淋巴细胞计数(TLC)和红细胞计数(RBC)异常发生率分别为53.62%、44.54%、53.98%、59.12%、43.17%和39.39%,其中,城市和农村老年住院患者贫血发生率、TP异常发生率、ALB异常发生率、RBC异常发生率差异均有统计学意义(χ²=21.72、32.85、38.23、21.07,均P<0.05)。结论 随着年龄的增长,农村地区老年住院患者的营养风险和营养不良发生率高于城市地区,需要社会和家庭更加关注农村老年患者的营养状况,及时调整膳食结构和食物品种搭配,合理补充各类营养素。     

Nutritional status in Europe: methods and results

Presented here is an analysis and documentation of the nutritional situation in 14 European countries. Collection methods and available data about the most common nutritional status assessment indicators are described. Prevalence of adult obesity varied considerably in the 14 countries, ranging from 6% to 31%. The mean fat intake of adults exceeded the population goal of less than 30% of energy in virtually all of the 14 countries. Dietary fiber, folate, vitamin D, and (excessive) sodium intake did not meet recommended levels. Strategies addressing the inadequacies in European diets are needed to improve the nutritional situation in Europe.     

Nutritional status of elderly patients with venous ulceration of the leg–report of a pilot study

Twenty elderly patients who attended the wound-healing research unit for treatment of a chronic leg ulcer took part in this pilot study. Nutritional analysis showed the diet to be poor generally, with mean energy, zinc and vitamin C intakes falling below the EAR and/or RNI for people of this age-group. Iron intake and quality of protein in the diet also gave cause for concern. While no firm conclusions regarding the impact of nutrition on healing can be drawn from this study, these preliminary results suggest that this group of patients is at risk nutritionally.     

不同专业大学生营养状况及相关因素分析

目的 了解大学生的营养状况,医学和非医学专业学生的营养知识知晓率、营养态度及行为.方法 采取整群随机抽样法,抽取1 592名在校学生进行问卷调查;使用体质指数评价学生的营养状况;应用X~2检验进行分析.结果 医学生在营养知识问题和日常饮食上的及格率为95.4%,74.8%,非医学生为83.2%,67.3%,差异有统计学意义(P=0.000,0.001),但是二者在营养状况和营养态度上却没有明显差异;医学生和非医学生分别有633人(77.2%)和534人(69.0%)每天都吃早餐,分别有793人(96.8%)和732人(94.7%)选择在学校餐厅早餐,差异均有统计学意义(P<0.01);大学生对营养知识了解掌握情况不佳,大多数学生都有好的态度,但却不能付诸行动;多因素Logistic回归分析结果显示,与营养状况有关的危险因素有偏食和晚上加餐,保护因素有母亲文化程度和每天吃中餐.结论 大学生膳食健康状况不容乐观,应普及大学营养知识教育.     

Factors associated with health-related quality of life among hemodialysis patients in the DOPPS

Objective To identify modifiable factors associated with health-related quality of life (HRQOL) among chronic hemodialysis patients. Methods Analysis of baseline data of 9,526 hemodialysis patients from seven countries enrolled in phase I of the Dialysis Outcomes and Practice Patterns Study (DOPPS). Using the Kidney Disease Quality of Life Short Form (KDQOL-SF^TM), we determined scores for 8 generic scale summaries derived from these scales, i.e., the physical component summary [PCS] and mental component summary [MCS], and 11 kidney disease- targeted scales. Regression models were used to adjust for differences in comorbidities and sociodemographic and treatment factors. The Benjamini–Hochberg procedure was used to correct P-values for multiple comparisons. Results Unemployment and psychiatric disease were independently and significantly associated with lower scores for all generic and several kidney disease-targeted HRQOL measures. Several other comorbidities, lower educational level, lower income, and hypoalbuminemia were also independently and significantly associated with lower scores of PCS and/or MCS and several generic and kidney disease-targeted scales. Hemodialysis by catheter was associated with significantly lower PCS scores, partially explained by the correlation with covariates. Conclusion Associations of poorer HRQOL with preventable or controllable factors support a greater focus on psychosocial and medical interventions to improve the well-being of hemodialysis patients. An erratum to this article can be found at     

32例透析患者蛋白质入量观察

32例常规慢性充分透析消瘦患者,经调整蛋白质的入量,使PCR.1.1～1.3g·kg~(-1)·d~(-1).患者3个月内干体重明显增加1.41±0.74kg,白蛋白增加1.9±0.82g%.因此对这些患者应补充生物效价高的蛋白质,主要是动物蛋白.PCR1.1～1.3g·kg~(-1)·d~(-1)则表示蛋白质摄入适当,能维持氮平衡.     

评价血液透析患者营养状况指标的选择及意义

目的：对评价血液透析患者营养状况的指标进行筛选和探讨。方法：采用统计学的R型聚类分析和相关分析方法，对营养指标进行筛选，分析透析时间和年龄对营养状况的影响。选择相对体重、上臂中部肌肉周径、三头肌皮褶厚度、白蛋白、转铁蛋白和纤维连接蛋白作为典型指标，这些指标相互间存在着较好的相关关系。结果：透析治疗时间及年龄对营养状况无显著影响。结论：上述六项指标可作为评价血透患者营养状况的典型指标，这有助于对血透患者的营养状况作定期的评价和监测。     

Fast and simple screening for nutritional status in hospitalized, elderly people

BACKGROUND: Undernutrition has been frequently reported among hospitalized elderly patients. The aim of this study was to evaluate the mini nutrition assessment (MNA) and a screening sheet for malnutrition (SSM) by full nutritional assessment (FNA) in elderly people, and to construct a shorter screening method by combining important questions from MNA and SSM. Having a screening tool as fast and simple as possible could increase its use in clinical routines. METHODS: FNA, MNA and SSM were carried out on 60 hospitalized patients (>65 years). Sensitivity and specificity for MNA and SSM were calculated in comparison with FNA. In order to construct a short and simple screening tool, questions from the two screening tools, which differed significantly between mal- and well-nourished patients, were used in a multivariate, stepwise linear regression. The regression model was simplified to be suitable in clinical routines. RESULTS: Malnourishment was diagnosed by FNA in 58.3% of the elderly patients, with no gender difference. Body mass index, unintended weight loss, recent surgery and loss of appetite were predictors of malnutrition in the regression model (R(2) = 60.1%). The sensitivity and specificity of the simplified regression model were 89 and 88%, respectively, which was more precise than MNA (77 and 36%) and SSM (89 and 60%). CONCLUSION: According to FNA, malnutrition is frequent in elderly hospitalized patients. Four questions are sufficient to conduct precise nutritional screening for malnutrition in elderly hospitalized patients. This new screening tool should be verified in other samples.     

The role of nutritional status in the relationship between diabetes and health-related quality of life

BACKGROUND/OBJECTIVESThe association between nutritional status and health-related quality of life (HRQoL) among patients with type 2 diabetes mellitus (T2DM) is not fully understood. This study was conducted to understand the role of nutritional status on HRQoL among people with and without T2DM.SUBJECTS/METHODSStructured survey and direct measurement of anthropometric data were conducted among people with and without T2DM. Nutritional status was measured with Mini Nutritional Assessment tool and HRQoL was measured with a 36-item Short Form Healthy Survey. Data collection was conducted in Chuncheon, South Korea with 756 participants who are older than 40 yrs of age.RESULTSThis study found that overall HRQoL were significantly lower in people with T2DM than people without T2DM after controlling for key covariates. When stratified by nutritional status, a greater degree of negative impact of T2DM on overall physical HRQoL was observed among well-nourished or at risk of malnutrition, whereas significant and more evident negative impact of diabetes on overall psychological HRQoL was observed only among malnourished.CONCLUSIONSThe study results suggest the role of nutritional status among people with T2DM on overall, especially psychological aspects of HRQoL. Future longitudinal or intervention studies are warranted to test the impact of nutritional status on HRQoL among people with T2DM.     

杭州市中小学生营养状况及影响因素分析

目的 了解浙江省杭州市中小学生营养状况及其影响因素,为制定中小学生营养相关干预措施提供科学依据。方法 采用分层整群随机抽样方法,从杭州市学生健康监测与预警管理信息系统抽取2009-2010学年共118 430名学生的健康检查资料,根据身高、体重、年龄等对学生营养状况等级进行评价,采用多分类多元logistic回归分析营养状况的影响因素。结果 在受检的61 645名男生中,营养不良、较低体重、正常体重、超重和肥胖者分别占13.0%、38.4%、27.9%、5.4%和15.3%,在受检的56 785名女生中,分别占10.3%、39.7%、37.0%、4.7%和8.3%,男生和女生营养状况分布差异有统计学意义(Z_c＝-5.321,P=0.000),且在青春期前、青春中期、青春晚期和青年早期4个发育阶段的分布差异均有统计学意义(Z_c=-15.253、-20.938、-5.161、-20.118,均P=0.000);男生较女生更易发生营养问题(营养不良和较低体重OR＝1.380,超重和肥胖OR＝2.081,均P=0.000),城区学生较郊县学生更易发生超重和肥胖(OR＝1.353,P=0.000),不易发生营养不良和较低体重(OR＝0.815,P=0.000)。结论 杭州市中小学生较低体重比例较高,而城区学生超重和肥胖情况也不容忽视;男生的营养问题较为突出,需据此采取有针对性的措施以改善现状。