摘要
目的探讨于都地区重症肺炎患儿营养风险与不良临床结局的关系。方法选择于都地区某医院2015年9月至2017年9月148例重症肺炎患儿作为研究对象,采用儿科营养不良评估筛查工具(STAMP)对患儿进行营养评估,根据STAMP评分分为低度营养风险组(LR组,61例)、中度营养风险组(MR组,53例)以及高度营养风险组(HR组,34例)。检测所有患儿内分泌代谢指标(瘦素、脂联素、胰岛素样生长因子-1、非酯化脂肪酸、转铁蛋白、清蛋白、前清蛋白及视黄醇结合蛋白)水平,观察不良临床结局发生情况,分析营养风险与不良临床结局之间是否具有相关性。结果3组患儿转铁蛋白、清蛋白水平比较,差异均无统计学意义(P>0.05);LR组患儿瘦素、脂联素、胰岛素样生长因子-1、前清蛋白以及视黄醇结合蛋白水平明显高于MR组、HR组,MR组高于HR组,差异均有统计学意义(P<0.05);LR组非酯化脂肪酸水平明显低于MR组、HR组,MR组低于HR组,差异均有统计学意义(P<0.05)。3组患儿病死率差异无统计学意义(P>0.05);LR组机械通气率、入住ICU率以及并发症发生率明显低于MR组、HR组,MR组低于HR组,差异均有统计学意义(P<0.05)。重症肺炎患儿营养风险与机械通气率、入住ICU率以及并发症发生率呈正相关(P<0.05),与病死率无相关性(P>0.05)。结论营养风险筛查对重症肺炎患儿的预后评估具有重要价值,高度营养不良的患儿临床预后较差,应尽早给予营养支持,改善临床结局。
Objective To study the correlation between the nutrition risks with adverse outcomes in children patients with severe pneumonia in Yudu area.Methods One hundred and forty-eight children patients with severe pneumonia treated in a hospital from September 2015 to September 2017 were selected as the study subjects.The Screening Tool for Assessment of Malnutrition in Pediatrics(STAMP)was used to evaluate the children′s nutrition condition.The patients were divided into the low nutrition risk group(LR group,61 cases),moderate nutrition risk group(MR group,53 cases)and high nutrition risk group(HR group,34 cases)according to the scores of STAMP.The endocrinological indicators[leptin,adiponectin,insulin like growth factor 1(IGH-1),non-esterified fatty acid(NEFA),transferring,albumin,prealbumin and retinol binding protein(RBP)]were detected in all cases.The adverse clinical outcomes were observed.The correlation between the nutrition risks with adverse clinical outcomes was analyzed.Results The levels of transferrin and albumin had no statistical difference among the three groups(P>0.05);the levels of leptin,adiponectin,IGF-1,prealbumin and RBP in the LR group were significantly higher than those in the MR group and the HR group,moreover the MR group was higher than the HR group,and the differences were statistically significant(P<0.05);the level of NEFA in the LR group was significantly lower than that in the MR group and the HR group,moreover the MR group was lower than the HR group,and the difference was statistically significant(P<0.05);the fatality rate had no statistical difference among the three groups(P>0.05);the mechanical ventilation rate,rate of entering ICU and incidence rate of complications in the LR group were significantly lower than those in the MR group and the HR group,moreover the MR group was lower than the HR group,and the differences were statistically significant(P<0.05);the nutrition risk in the children patients with severe pneumonia was positively correlated with the mechanical ventilation r
作者
谢起理
丁兆辉
XIE Qili;DING Zhaohui(Yudu County Center for Disease Control and Prevention,Ganzhou,Jiangxi 342300,China;Department of Pulmonary Disease,Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang,Jiangxi 330006,China)
出处
《检验医学与临床》
CAS
2019年第22期3321-3323,共3页
Laboratory Medicine and Clinic
