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31.
目的 探讨血液透析患者C-反应蛋白与贫血、营养不良及感染的关系。方法 将72例血液透析患者分为感染组和非感染组,检测其C-反应蛋白(CRP)、血红蛋白(Hb、)、血清白蛋白(ALB)、转铁蛋白(TF)、血肌酐(Scr)、甘油三酯(TG)及总胆固醇(Tch)。结果 感染组CRP水平明显高于非感染组(P〈0.01),感染组Hb、ALB、TF明显低于非感染组(P〈0.01),两组间Scr、TG、Tch比较差异无显著性(P〉0.05)。血液透析患者CRP水平与Hb、ALB、TF呈负相关(P〈0.01),CRP水平与TG、Tch、Scr的相关性不显著(P〉0.05)。结论 血液透析患者CRP水平可反映机体贫血、营养状况及炎症反应。  相似文献   
32.
目的 了解汝城县农村义务教育学生营养健康状况,为该县实施营养改善计划提供指导与依据. 方法 按照《汝城县农村义务教育学生营养改善计划营养健康状况监测评估技术方案》的要求,随机抽取7 381名学生进行体格检测,检测数据输入《营养健康状况监测评估系统》导出成Excel数据格式进行分析. 结果 汝城县农村义务教育学生身高均数与体重均数与2010年全国学生体质调研资料中农村儿童身高、体重的平均水平比较,除6岁年龄组的女生体重比较差异无统计学意义外,其它差异均有统计学意义,均低于2010年全国学生体质调研资料中农村儿童身高、体重的平均水平.男生营养不良率为23.99%,超重肥胖率为7.64%;女生营养不良率为16.97%,超重肥胖率为5.06%,男、女生比较差异均有统计学意义(x2营养不良率=54.42、x2超重肥胖率=20.02,P<0.01),并且反映出男女生过去或者慢性营养不良率高于近期或者急性营养不良率. 结论 汝城县5~16岁农村义务教育学生营养健康问题突出,各年龄组身高、体重水平均低于2010年全国学生体质调研资料中农村儿童身高、体重的平均水平.为努力改善农村义务教育学生的身体素质及健康状况,有关部门要进一步重视,提供平衡膳食,改变供餐模式,使营养改善计划有效的实施.  相似文献   
33.

Background

Malnutrition and frailty are two geriatric syndromes that significantly affect independent living and health in community-dwelling older adults. Although the pathophysiology of malnutrition and physical frailty share common pathways, it is unknown to what extent these syndromes overlap and how they relate to each other.

Methods

A systematic review was performed resulting in a selection of 28 studies that assessed both malnutrition and frailty in community-dwelling older adults. Furthermore, a meta-analysis was performed on 10 studies that used Mini- Nutritional Assessment and the Fried frailty phenotype to estimate the prevalence of malnutrition within physical frailty and vice versa.

Results

In the systematic review, 25 of the 28 studies used the Mini-Nutritional Assessment (long or short form) for malnutrition screening. For frailty assessment, 23 of the 28 studies focused on the physical frailty phenotype, of which 19 followed the original Fried phenotype. Fifteen studies analyzed the association between malnutrition and frailty, which was significant in 12 of these. The meta-analysis included 10 studies with a total of 5447 older adults. In this pooled population of community-dwelling older adults [mean (standard deviation) age: 77.2 (6.7) years], 2.3% was characterized as malnourished and 19.1% as physically frail. The prevalence of malnutrition was significantly associated with the prevalence of physical frailty (P < .0001). However, the syndromes were not interchangeable: 68% of the malnourished older adults was physically frail, whereas only 8.4% of the physical frail population was malnourished.

Conclusions

The systematic review and meta-analysis revealed that malnutrition and physical frailty in community-dwelling older adults are related, but not interchangeable geriatric syndromes. Two out of 3 malnourished older adults were physically frail, whereas close to 10% of the physically frail older adults was identified as malnourished.  相似文献   
34.
目的:观察生长激素加强危重病人应用全肠外营养支持的效果。方法:对严重应激(7例)和重度营养不良(9例)共16例病人采用低热量肠外营养加重组生长激素联合治疗,并与仅用TPN治疗的同类病人作对照研究,治疗后分别测定体重、血清白蛋白,前白蛋白和转铁蛋白及免疫球蛋白,计算氮平衡,观察精神状态。结果:治疗组比对照组在氮平衡、前白蛋白和转铁蛋白有明显改善(P<0.01),血清白蛋白,免疫球蛋白亦有明显增高(P<0.05),精神状态普遍较好,获得了较好的临床疗效。结论:低热量肠外营养加重组生长激素联合治疗是机体病理状态下一种较为理想的营养支持方法  相似文献   
35.

Background

The validity of the Malnutrition Screening Tool (MST) in geriatric rehabilitation has been evaluated in a research environment but not in professional practice.

Objective

In older adults admitted to rehabilitation, this study was undertaken to compare the MST scoring agreement (inter-rater reliability) between health professionals with and without malnutrition risk and screening training; to evaluate the concurrent validity of the MST completed by the trained and untrained health professionals compared to the International Classification of Diseases, Tenth Revision, Australian Modification using different MST score cutoffs; and to determine whether patient characteristics were associated with MST scoring accuracy when completed by health professionals without malnutrition risk and screening training.

Design

This was an observational, cross-sectional study.

Participants/setting

Fifty-seven older adults (mean age=79.1±7.3 years) were recruited from August 2013 to February 2014 from two rural rehabilitation units in New South Wales, Australia.

Main outcome measures

MST, International Classification of Diseases, Tenth Revision, Australian Modification, classification of malnutrition, and patient characteristics were used to measure outcomes.

Statistical analysis performed

Measures of diagnostic accuracy generated from a contingency table, receiver operating characteristic curve, and Spearman’s correlation were used.

Results

The MST scores completed by health professionals with and without malnutrition risk and screening training showed moderate correlation and fair agreement (rs=0.465; P=0.001; κ=0.297; P=0.028). When compared to the International Classification of Diseases, Tenth Revision, Australian Modification, the untrained MST administration showed moderate diagnostic accuracy (sensitivity 56.5%, specificity 83.3%), but increasing the MST score to ≥3 caused the sensitivity of both the trained and untrained MST administration to decrease (56.5% and 22.9%, respectively).

Conclusions

The application of the MST by health professionals without malnutrition risk and screening training in rehabilitation may not provide sufficient accuracy in identifying patients with malnutrition risk. Using an MST score of ≥2 to indicate malnutrition risk is recommended, as increasing the MST cutoff score to ≥3 is likely to have insufficient accuracy, even when completed by health professionals with malnutrition risk and screening training. Research evaluating the impact of providing rehabilitation staff with regular and ongoing training in completing malnutrition screening and referral pathways is warranted.  相似文献   
36.
目的分析西部贫困农村5岁以下儿童营养状况与医疗费用的关系。方法采用多阶段分层整群随机抽样的方法,于2009年在西部6省12县贫困农村共调查8141名5岁以下儿童。按WHO推荐标准将调查儿童分为营养不良与营养良好两组,用SAS 9.1软件进行分析比较。结果西部贫困农村5岁以下儿童营养不良率为18.9%;男孩营养不良率(19.9%)显著高于女孩(17.7%,P<0.05);营养不良组近两周内腹泻患病率(9.0%)以及上呼吸道感染患病率(27.9%)显著高于营养良好组(6.9%,25.4%,P<0.05);营养不良组的医疗费用(785.1元)显著高于营养良好组的医疗费用(696.6元,P<0.05);营养不良儿童的门诊就诊率(27.5%)显著高于营养良好儿童的门诊就诊率(25.0%,P<0.05)。结论西部贫困农村儿童营养不良问题仍有待改善,营养状况对儿童的患病率及医疗费用有影响。  相似文献   
37.
The Global Leadership Initiative on Malnutrition (GLIM) has achieved a consensus for the diagnosis of malnutrition in recent years. This study aims to determine the prognostic effect of the GLIM after cardiac surgery. A total of 603 patients in the training cohort and 258 patients in the validation cohort were enrolled in this study. Perioperative characteristics and follow-up data were collected. A nomogram based on independent prognostic predictors was developed for survival prediction. In total, 114 (18.9%) and 48 (18.6%) patients were defined as being malnourished according to the GLIM criteria in the two cohorts, respectively. Multivariate regression analysis showed that GLIM-defined malnutrition was an independent risk factor of total complication (OR 1.661, 95% CI: 1.063–2.594) and overall survival (HR 2.339, 95% CI: 1.504–3.637). The c-index was 0.72 (95% CI: 0.66–0.79) and AUC were 0.800, 0.798, and 0.780 for 1-, 2-, and 3-year survival prediction, respectively. The calibration curves of the nomogram fit well. In conclusion, GLIM criteria can efficiently identify malnutrition and has a prognostic effect on clinical outcomes after cardiac surgery. GLIM-based nomogram has favorable performance in survival prediction.  相似文献   
38.
目的 探讨营养不良患儿血酰基肉碱谱特点及用于代谢病的鉴别.方法 收集营养不良患儿13例,同期同年龄段非代谢病患儿214例作为对照组.入院时空腹采集末梢血制成千血片,串联质谱非衍生化法检测其肉碱和多种酰基肉碱浓度.结果 脂肪酸氧化分解相关的脂酰基肉碱,营养不良组从十八碳脂酰基肉碱至乙酰基肉碱,包括酮体酰基肉碱,即丙二酰基肉碱和羟基丁酰基肉碱都有不同程度增高,以中链酰基肉碱增高明显,其中营养不良组癸酰基肉碱为(0.203 ±0.105) μmol/L,超出正常参考值范围(0~0.200 μmol/L),显著高于对照组[0.054±0.030)μmol/L,P<0.001].氨基酸分解相关的丙酰基肉碱、戊酰基肉碱、羟基戊酰基肉碱和戊二酰基肉碱等,营养不良组和对照组比较差异均无统计学意义(均P>O.05).结论 营养不良患儿血中脂肪酸代谢相关的酰基肉碱增高,以中链酰基肉碱增高明显,癸酰基肉碱略超出正常值等特点,可与中链酰基辅酶A脱氢酶缺乏症和多种酰基肉碱辅酶A脱氢酶缺乏症等疾病鉴别.  相似文献   
39.
40.
目的 了解云南省肿瘤医院收治的胃癌患者营养风险情况及营养支持治疗现状.方法 用NRS2002作为筛查工具对云南省肿瘤医院收治的部分胃癌患者进行营养风险筛查,同时调查胃癌患者营养支持治疗情况.结果 (1)本组320例胃癌患者中63%的患者存在营养风险; (2)存在营养风险的胃癌患者血清白蛋白不一定低下、体重指数低下所占比例较高,但体重指数正常的患者同样存在营养风险,存在营养风险的胃癌患者中性别比较无统计学意义(P=0.149),分期比较有统计学意义(P=0.030),年龄比较(<60岁与≥60岁)有统计学意义(P=0.009); (3)存在营养风险的患者中未实施营养支持治疗的占43%;无营养风险的患者实施营养支持治疗的占10%,营养支持治疗的方法主要为肠外营养(PN)、肠内营养(EN)、肠外营养+肠内营养(PN+EN).结论 (1)胃癌患者营养风险发生率较高,应进行营养风险筛查.(2)存在营养风险的胃癌患者血清白蛋白不一定都有下降、体重指数低下所占比例较高,但体重指数正常的患者同样存在营养风险,胃癌患者营养风险与性别无关,年龄越大的患者营养风险发生率越高,分期越晚的患者营养风险发生率越高.(3)胃癌营养支持治疗需进一步规范.  相似文献   
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