河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (8): 876-880.doi: 10.3969/j.issn.1007-3205.2021.08.003

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慢性阻塞性肺疾病急性加重患者营养风险的评估及其对预后的预测价值

  

  1. 河北北方学院附属第一医院急诊ICU，河北 张家口  075000
  • 出版日期:2021-08-25 发布日期:2021-08-27
  • 作者简介:王慧（1985-），女，河北唐山人，河北北方学院附属第一医院主治医师，医学硕士，从事肺部疾病诊治研究。
  • 基金资助:
    河北省医学科学研究课题计划（20190903）

Nutritional risk assessment of patients with acute exacerbation of chronic obstructive pulmonary disease and its predictive value on prognosis

  1. Department of Emergency ICU, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China
  • Online:2021-08-25 Published:2021-08-27

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摘要： 目的  评估慢性阻塞性肺疾病急性加重（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）患者的营养风险及其对预后的预测价值。
方法  选择AECOPD患者86例作为AECOPD组，稳定期COPD患者60例及健康者60例分别作为稳定期COPD组及对照组。采用营养风险筛查NRS 2002进行营养风险评估并分为0~2分的无营养风险患者和3~7分的有营养风险患者。按照AECOPD患者28 d存活情况评估预后，采用Kaplan-Meier曲线分析预后差异、ROC曲线分析NRS 2002总分对预后的预测价值、Logistic回归模型分析预后的影响因素。
结果  AECOPD组NRS 2002总分、有营养风险比例均高于稳定期COPD组及对照组（P＜0.05）；经Kaplan-Meier曲线分析，AECOPD组中有营养风险患者的28 d累积存活率低于无营养风险患者（P＜0.05）；经ROC曲线分析，NRS 2002总分对AECOPD患者的28 d存活情况具有预测价值（P＜0.05）；经Logistic回归分析，年龄、白蛋白、多重耐药、APACHE Ⅱ评分、有营养风险是AECOPD患者预后的影响因素（P＜0.05）。
结论  营养风险与AECOPD患者病情加重及28 d预后有关，针对性地降低营养风险可能有助改善AECOPD的预后。


关键词: 肺疾病, 慢性阻塞性 , , 营养风险, 预后

Abstract: Objective  To evaluate the nutritional risk of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and its predictive value on prognosis. 
Methods  A total of 86 AECOPD patients were selected as AECOPD group, and 60 patients with stable COPD and 60 healthy people were selected as stable COPD group and control group respectively. Nutrition Risk Screening 2002(NRS 2002) was used for nutritional risk assessment, and the patients were divided into non-nutritional risk patients with 0-2 points and nutritional risk patients with 3-7 points.The prognosis was assessed according to the 28-day survival of AECOPD patients. Kaplan Meier curve was used to analyze the difference of prognosis, ROC curve was used to analyze the predictive value of NRS 2002 score on prognosis, and Logistic regression model was used to analyze the influencing factors of prognosis. 
Results  The NRS 2002 score and the proportion of nutritional risk in AECOPD group were higher than those in stable COPD group and control group(P＜0.05). Kaplan Meier curve analysis showed that the 28-day cumulative survival rate of patients with nutritional risk in AECOPD group was lower than that in patients without nutritional risk(P＜0.05). ROC curve analysis showed that NRS2002 score had predictive value for 28-day survival of AECOPD patients(P＜0.05). Logistic regression analysis showed that age, ALB, multi-drug resistance, APACHE Ⅱ score and nutritional risk were the influencing factors of prognosis of AECOPD patients(P＜0.05). 
Conclusion  Nutritional risk is related to the severity and 28-day prognosis of AECOPD patients. Targeted reduction of nutritional risk may help improve the prognosis of AECOPD.


Key words: pulmonary disease, chronic obstructive, nutritional risk, prognosis

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