应用NRS2002方法对肺结核合并肺部感染患者的营养风险筛查和分析

目的研究肺结核合并肺部感染患者的营养风险、营养不足发生率,并与单纯肺结核患者进行比较。方法采用NRS2002营养风险筛查方法,随机选择2012年4月~10月新入院肺结核患者200例,在入院2天内和住院2周时进行营养风险筛查初查和复查,并按是否合并肺部感染,分为研究组(90例)和对照组(110例),比较两组营养不足、营养风险的发生率,进行统计分析。营养不足判定标准为体重指数BMI18.5kg/m2、血清白蛋白sALB30 g/L。结果总的营养风险和营养不足发生率分别为82%(164/200)和43.5%(87/200)。刚入院时研究组的营养风险发生率(88.9%)比对照组高(76.4%),P0.05;治疗2周后复查,两组的营养风险发生率明显降低,P值均0.01,研究组(53.3%)仍然明显高于对照组(39.1%),P0.05;营养不足率组间及组内比较均无明显差别,P值均0.05。结论肺结核合并肺部感染住院患者的营养风险和营养不足发生率较高,应推广和使用NRS2002营养风险筛查方法,作为临床实施营养支持的参考依据。

Nutritional risk screening in pulmonary tuberculosis patients complicated with pulmonary infection

Objective To study the incidence of malnutrition and nutrition risk in pulmonary tuberculosis patients complicated with pulmonary infection. Methods Totally 200 adult tuberculosis patients were enrolled in this study. All patients were divided into two groups according to pulmonary infection. The nutrition risks were screened in two days after admission and then two weeks later by Nutrition Risk Screening 2002 （NRS2002）. Body mass index （BMI） lower than 18. 5 kg/m2 and serum albumin （sALB） lower than 30g/L were regarded as undernutrition. Re-sults 82% patients were judged at the risk of malnutrition and 43. 5% patients with malnutrition. The incidence of nutrition risk in the research group （88. 9%） was higher than that in the control group （76. 4%） （P〈0. 05）. Two weeks later, the incidence of nutrition risk in the two group were significantly lower than two days after admission （ P〈0. 01）. There was no significant difference in the incidence of malnutrition between the two groups （P〉0. 05）. Conclusion Tuberculosis patients complicated with pulmonary infection have high nutritional risk or undernutrition. NRS2002 should be promoted in the nutrition assessment.