营养状况对老年肝硬化住院患者临床结局的影响

doi:10.3969/j.issn.1004-583X.2019.02.007

临床荟萃

营养状况对老年肝硬化住院患者临床结局的影响

中国科学院大学重庆仁济医院重庆市第五人民医院消化内科，重庆 400062

出版日期:2019-02-20 发布日期:2019-03-11
通讯作者: 通信作者：郝亚琴，Email：liuyue291515@158.com
基金资助:
重庆市卫计委基金资助项目--深夜点心联合乳果糖对肝硬化患者营养不良及血清瘦素水平的影响 (2016MSXM143)

Effect of nutritional status on clinical outcomes in elderly patients with hepatic cirrhosis

Department of Gastroenterology, Chongqing Renji Hospital, University of Chinese Academy of Sciences,
Chongqing No.5 People's Hospital, Chongqing 400062, China

Online:2019-02-20 Published:2019-03-11
Contact: Corresponding author: Hao Yaqin, Email: liuyue291515@158.com

摘要/Abstract

摘要： 目的探讨营养状况对老年肝硬化住院患者临床结局的影响。方法收集2012年11月至2018年7月重庆市第五人民医院消化内科收治的肝硬化患者465例，其中老年肝硬化患者236例，采用营养风险筛查 2002（NRS2002）评估老年肝硬化住院患者的营养风险，并按照预后分为存活组和死亡组，比较两组患者的临床资料，采用 logistic回归模型分析影响其预后的危险因素。结果存在营养风险老年肝硬化住院患者死亡率明显高于无营养风险者，两者比较差异有统计学意义（P＜0.05）。死亡组终末期肝病模型（MELD）评分、NRS2002评分、血清白蛋白、血清钠和Child Pugh分级与存活组比较差异均有统计学意义（P＜0.05）。多因素分析表明，MELD评分、凝血酶原时间、血清钠、Child Pugh分级及消化道出血是存在营养风险的老年肝硬化住院患者死亡的独立危险因素。结论老年肝硬化患者营养风险发生率高，相应地其住院期间死亡风险高，MELD评分、凝血酶原时间、血清钠、Child Pugh 分级及消化道出血是存在营养风险的老年肝硬化住院患者死亡的独立危险因素，因此，应重视老年肝硬化患者的营养评估及营养治疗。

关键词: 肝硬化, 营养风险, 营养评估

Abstract: Objective To explore the effect of nutritional status on clinical outcomes in elderly patients with hepatic cirrhosis.Methods A total of 465 patients with liver cirrhosis was collected from November 2012 to July 2018, including 236 elderly patients with hepatic cirrhosis. Nutritional risk screening 2002 (NRS2002) was used to evaluate the nutritional risk of elderly inpatients with liver cirrhosis, and the patients were divided into the survival group and the death group according to the prognosis, logistic regression model analysis was used to evaluate the risk factors influencing the prognosis of patients.Results The mortality rate of elderly inpatients with hepatic cirrhosis suffering nutritional risk was significantly higher than that of those without nutritional risk (P<0.05). Compared with the survival group, MELD score, NRS2002 score, serum albumin, serum sodium and Child Pugh grading in the death group was significantly different (P<0.05). Multivariate analysis showed that endstage liver disease model (MELD) score, prothrombin time, serum sodium, Child Pugh grading and gastrointestinal bleeding were independent risk factors for death in elderly hospitalized patients with hepatic cirrhosis suffering nutritional risk. Conclusion The elderly patients with hepatic cirrhosis have a high incidence of nutritional risk and death during hospitalization. MELD score, aprothrombin time, serum sodium, Child Pugh grading and gastrointestinal bleeding are independent risk factors for death of elderly patients with hepatic cirrhosis suffering nutritional risk. Therefore, nutritional assessment and treatment in elderly patients with hepatic cirrhosis should be paid attention.

Key words: liver cirrhosis;nutrition risk, nutrition assessment

黄光明，谷达会，郝亚琴，程文会，何治军. 营养状况对老年肝硬化住院患者临床结局的影响[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2019.02.007.

Huang Guangming, Gu Dahui, Hao Yaqin, He Zhijun. Effect of nutritional status on clinical outcomes in elderly patients with hepatic cirrhosis[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2019.02.007.

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https://huicui.hebmu.edu.cn/CN/Y2019/V34/I2/128

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营养状况对老年肝硬化住院患者临床结局的影响

Effect of nutritional status on clinical outcomes in elderly patients with hepatic cirrhosis

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