Chinese General Practice ›› 2023, Vol. 26 ›› Issue (06): 665-671.DOI: 10.12114/j.issn.1007-9572.2022.0553
Special Issue: 营养最新文章合集
• Original Research • Previous Articles Next Articles
Received:
2022-07-13
Revised:
2022-08-22
Published:
2023-02-20
Online:
2022-09-15
Contact:
ZENG Xi
About author:
通讯作者:
曾西
作者简介:
基金资助:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0553
组别 | 例数 | 性别(男/女) | 年龄( | 高血压(有/无) | 糖尿病(有/无) | 卒中后肺炎(有/无) | 卒中后焦虑抑郁(有/无) | OSAHS (有/无) | 吸烟饮酒史(无/仅吸烟/仅饮酒/吸烟饮酒) | 营养支持方式(仅经口进食/仅NGT/仅IOE/合并PN) | WST评分( | NIHSS评分( |
---|---|---|---|---|---|---|---|---|---|---|---|---|
入院时营养正常组 | 156 | 90/66 | 62.1±10.9 | 105/51 | 37/119 | 20/136 | 32/124 | 8/148 | 88/10/12/46 | 90/11/38/17 | 3.1±1.6 | 15.1±5.7 |
入院时营养不良组 | 21 | 13/8 | 69.0±10.5 | 17/4 | 7/14 | 6/15 | 5/16 | 1/20 | 8/3/5/5 | 3/5/6/7 | 4.5±1.0 | 17.9±6.5 |
χ2(t)值 | 0.135 | -2.134a | 1.609 | 0.916 | 3.664 | 0.122 | 0.005 | 7.921 | 19.390 | -3.313a | -1.529a | |
P值 | 0.713 | 0.045 | 0.205 | 0.338 | 0.056 | 0.727 | 0.943 | 0.048 | <0.001 | 0.003 | 0.142 |
Table 1 Univariate analysis of influencing factors of nutritional status in 177 stroke patients on admission
组别 | 例数 | 性别(男/女) | 年龄( | 高血压(有/无) | 糖尿病(有/无) | 卒中后肺炎(有/无) | 卒中后焦虑抑郁(有/无) | OSAHS (有/无) | 吸烟饮酒史(无/仅吸烟/仅饮酒/吸烟饮酒) | 营养支持方式(仅经口进食/仅NGT/仅IOE/合并PN) | WST评分( | NIHSS评分( |
---|---|---|---|---|---|---|---|---|---|---|---|---|
入院时营养正常组 | 156 | 90/66 | 62.1±10.9 | 105/51 | 37/119 | 20/136 | 32/124 | 8/148 | 88/10/12/46 | 90/11/38/17 | 3.1±1.6 | 15.1±5.7 |
入院时营养不良组 | 21 | 13/8 | 69.0±10.5 | 17/4 | 7/14 | 6/15 | 5/16 | 1/20 | 8/3/5/5 | 3/5/6/7 | 4.5±1.0 | 17.9±6.5 |
χ2(t)值 | 0.135 | -2.134a | 1.609 | 0.916 | 3.664 | 0.122 | 0.005 | 7.921 | 19.390 | -3.313a | -1.529a | |
P值 | 0.713 | 0.045 | 0.205 | 0.338 | 0.056 | 0.727 | 0.943 | 0.048 | <0.001 | 0.003 | 0.142 |
组别 | 例数 | 性别(男/女) | 年龄( | 高血压(有/无) | 糖尿病(有/无) | 卒中后肺炎(有/无) | 卒中后焦虑抑郁(有/无) | OSAHS (有/无) | 吸烟饮酒史(无/仅吸烟/仅饮酒/吸烟饮酒) | 营养支持方式(仅经口进食/仅NGT/仅IOE/合并PN) | WST评分( | NIHSS评分( |
---|---|---|---|---|---|---|---|---|---|---|---|---|
住院7 d时营养正常组 | 120 | 67/53 | 56.2±10.6 | 79/41 | 27/93 | 11/109 | 26/94 | 6/114 | 67/6/13/34 | 81/9/27/3 | 2.7±1.6 | 12.2±6.2 |
住院7 d时营养不良组 | 57 | 36/21 | 64.5±10.2 | 43/14 | 17/40 | 15/42 | 11/46 | 3/54 | 29/7/4/17 | 12/7/17/21 | 4.2±1.4 | 17.5±6.0 |
χ2(t)值 | 0.852 | -4.399a | 1.665 | 1.110 | 9.069 | 0.131 | 0.006 | 3.580 | 52.149 | -4.225a | -3.135a | |
P值 | 0.356 | <0.001 | 0.197 | 0.292 | 0.003 | 0.717 | 0.941 | 0.311 | <0.001 | <0.001 | 0.003 |
Table 2 Univariate analysis of influencing factors of nutritional status in 177 stroke patients at 7 days of hospitalization
组别 | 例数 | 性别(男/女) | 年龄( | 高血压(有/无) | 糖尿病(有/无) | 卒中后肺炎(有/无) | 卒中后焦虑抑郁(有/无) | OSAHS (有/无) | 吸烟饮酒史(无/仅吸烟/仅饮酒/吸烟饮酒) | 营养支持方式(仅经口进食/仅NGT/仅IOE/合并PN) | WST评分( | NIHSS评分( |
---|---|---|---|---|---|---|---|---|---|---|---|---|
住院7 d时营养正常组 | 120 | 67/53 | 56.2±10.6 | 79/41 | 27/93 | 11/109 | 26/94 | 6/114 | 67/6/13/34 | 81/9/27/3 | 2.7±1.6 | 12.2±6.2 |
住院7 d时营养不良组 | 57 | 36/21 | 64.5±10.2 | 43/14 | 17/40 | 15/42 | 11/46 | 3/54 | 29/7/4/17 | 12/7/17/21 | 4.2±1.4 | 17.5±6.0 |
χ2(t)值 | 0.852 | -4.399a | 1.665 | 1.110 | 9.069 | 0.131 | 0.006 | 3.580 | 52.149 | -4.225a | -3.135a | |
P值 | 0.356 | <0.001 | 0.197 | 0.292 | 0.003 | 0.717 | 0.941 | 0.311 | <0.001 | <0.001 | 0.003 |
组别 | 例数 | 性别(男/女) | 年龄( | 高血压(有/无) | 糖尿病(有/无) | 卒中后肺炎(有/无) | 卒中后焦虑抑郁(有/无) | OSAHS (有/无) | 吸烟饮酒史(无/仅吸烟/仅饮酒/吸烟饮酒) | 营养支持方式(仅经口进食/仅NGT/仅IOE/合并PN) | WST评分( | NIHSS评分( |
---|---|---|---|---|---|---|---|---|---|---|---|---|
出院时营养正常组 | 142 | 83/59 | 56.2±10.9 | 100/42 | 35/107 | 18/124 | 28/114 | 9/133 | 80/10/11/41 | 88/9/34/11 | 2.6±1.5 | 13.4±5.7 |
出院时营养不良组 | 35 | 20/15 | 62.2±11.3 | 22/13 | 9/26 | 8/27 | 9/26 | 0/35 | 16/3/6/10 | 5/7/10/13 | 4.2±1.4 | 17.2±6.2 |
χ2(t)值 | 0.020 | -1.883a | 0.750 | 0.017 | 2.323 | 0.611 | 2.337 | 3.256 | 39.275 | -3.948a | -2.462a | |
P值 | 0.888 | 0.068 | 0.386 | 0.896 | 0.107 | 0.435 | 0.126 | 0.354 | <0.001 | <0.001 | 0.019 |
Table 3 Univariate analysis of influencing factors of nutritional status in 177 stroke patients at discharge
组别 | 例数 | 性别(男/女) | 年龄( | 高血压(有/无) | 糖尿病(有/无) | 卒中后肺炎(有/无) | 卒中后焦虑抑郁(有/无) | OSAHS (有/无) | 吸烟饮酒史(无/仅吸烟/仅饮酒/吸烟饮酒) | 营养支持方式(仅经口进食/仅NGT/仅IOE/合并PN) | WST评分( | NIHSS评分( |
---|---|---|---|---|---|---|---|---|---|---|---|---|
出院时营养正常组 | 142 | 83/59 | 56.2±10.9 | 100/42 | 35/107 | 18/124 | 28/114 | 9/133 | 80/10/11/41 | 88/9/34/11 | 2.6±1.5 | 13.4±5.7 |
出院时营养不良组 | 35 | 20/15 | 62.2±11.3 | 22/13 | 9/26 | 8/27 | 9/26 | 0/35 | 16/3/6/10 | 5/7/10/13 | 4.2±1.4 | 17.2±6.2 |
χ2(t)值 | 0.020 | -1.883a | 0.750 | 0.017 | 2.323 | 0.611 | 2.337 | 3.256 | 39.275 | -3.948a | -2.462a | |
P值 | 0.888 | 0.068 | 0.386 | 0.896 | 0.107 | 0.435 | 0.126 | 0.354 | <0.001 | <0.001 | 0.019 |
变量 | 赋值 |
---|---|
营养状况 | 营养正常=0,营养不良=1 |
年龄 | 实测值 |
卒中后肺炎 | 无=0,有=1 |
吸烟饮酒史 | 无=0,仅吸烟=1,仅饮酒=2,吸烟饮酒=3 |
营养支持方式 | 仅经口进食=1,仅NGT=2,仅IOE=3,合并PN=4 |
WST评分 | 实测值 |
NIHSS评分 | 实测值 |
Table 4 Assignment table of variables associated with influencing factors of nutritional status of stroke inpatients
变量 | 赋值 |
---|---|
营养状况 | 营养正常=0,营养不良=1 |
年龄 | 实测值 |
卒中后肺炎 | 无=0,有=1 |
吸烟饮酒史 | 无=0,仅吸烟=1,仅饮酒=2,吸烟饮酒=3 |
营养支持方式 | 仅经口进食=1,仅NGT=2,仅IOE=3,合并PN=4 |
WST评分 | 实测值 |
NIHSS评分 | 实测值 |
B | SE | Wald χ2值 | P值 | OR值 | 95%CI | |||
---|---|---|---|---|---|---|---|---|
入院时 | ||||||||
年龄 | 0.006 | 0.022 | 0.074 | 0.786 | 0.994 | (0.952,1.038) | ||
吸烟饮酒史(以无为参照) | ||||||||
仅吸烟 | 0.098 | 0.638 | 0.024 | 0.877 | 1.103 | (0.316,3.853) | ||
仅饮酒 | 1.453 | 0.900 | 2.602 | 0.107 | 4.274 | (0.732,24.967) | ||
吸烟饮酒 | 1.501 | 0.778 | 3.726 | 0.054 | 4.486 | (0.977,20.592) | ||
WST评分 | 0.750 | 0.215 | 12.196 | <0.001 | 2.118 | (1.390,3.226) | ||
住院7 d时 | ||||||||
年龄 | 0.038 | 0.017 | 4.853 | 0.028 | 1.035 | (1.001,1.070) | ||
营养支持方式(以仅经口进食为参照) | ||||||||
仅NGT | 0.696 | 0.922 | 0.569 | 0.451 | 2.005 | (0.329,12.227) | ||
仅IOE | 0.429 | 0.801 | 0.287 | 0.592 | 1.536 | (0.319,7.390) | ||
合并PN | 2.955 | 0.916 | 10.403 | 0.001 | 19.206 | (3.188,115.707) | ||
卒中后肺炎 | 0.779 | 0.537 | 2.104 | 0.147 | 2.180 | (0.737,5.576) | ||
WST评分 | 0.099 | 0.245 | 0.164 | 0.685 | 1.104 | (0.684,1.784) | ||
NIHSS评分 | 0.103 | 0.038 | 7.325 | 0.007 | 1.108 | (1.029,1.194) | ||
出院时 | ||||||||
营养支持方式(以仅经口进食为参照) | ||||||||
仅NGT | 2.604 | 1.034 | 6.348 | 0.012 | 13.518 | (1.783,102.493) | ||
仅IOE | 1.580 | 0.970 | 2.655 | 0.103 | 4.856 | (0.726,32.487) | ||
合并PN | 2.915 | 0.949 | 9.430 | 0.002 | 18.445 | (2.870,118.531) | ||
WST评分 | 0.044 | 0.278 | 0.025 | 0.875 | 0.957 | (0.555,1.652) | ||
NIHSS评分 | 0.035 | 0.041 | 0.751 | 0.386 | 1.036 | (0.956,1.122) |
Table 5 Multivariate Logistic regression analysis of influencing factors of nutritional status in stroke inpatients at different time points
B | SE | Wald χ2值 | P值 | OR值 | 95%CI | |||
---|---|---|---|---|---|---|---|---|
入院时 | ||||||||
年龄 | 0.006 | 0.022 | 0.074 | 0.786 | 0.994 | (0.952,1.038) | ||
吸烟饮酒史(以无为参照) | ||||||||
仅吸烟 | 0.098 | 0.638 | 0.024 | 0.877 | 1.103 | (0.316,3.853) | ||
仅饮酒 | 1.453 | 0.900 | 2.602 | 0.107 | 4.274 | (0.732,24.967) | ||
吸烟饮酒 | 1.501 | 0.778 | 3.726 | 0.054 | 4.486 | (0.977,20.592) | ||
WST评分 | 0.750 | 0.215 | 12.196 | <0.001 | 2.118 | (1.390,3.226) | ||
住院7 d时 | ||||||||
年龄 | 0.038 | 0.017 | 4.853 | 0.028 | 1.035 | (1.001,1.070) | ||
营养支持方式(以仅经口进食为参照) | ||||||||
仅NGT | 0.696 | 0.922 | 0.569 | 0.451 | 2.005 | (0.329,12.227) | ||
仅IOE | 0.429 | 0.801 | 0.287 | 0.592 | 1.536 | (0.319,7.390) | ||
合并PN | 2.955 | 0.916 | 10.403 | 0.001 | 19.206 | (3.188,115.707) | ||
卒中后肺炎 | 0.779 | 0.537 | 2.104 | 0.147 | 2.180 | (0.737,5.576) | ||
WST评分 | 0.099 | 0.245 | 0.164 | 0.685 | 1.104 | (0.684,1.784) | ||
NIHSS评分 | 0.103 | 0.038 | 7.325 | 0.007 | 1.108 | (1.029,1.194) | ||
出院时 | ||||||||
营养支持方式(以仅经口进食为参照) | ||||||||
仅NGT | 2.604 | 1.034 | 6.348 | 0.012 | 13.518 | (1.783,102.493) | ||
仅IOE | 1.580 | 0.970 | 2.655 | 0.103 | 4.856 | (0.726,32.487) | ||
合并PN | 2.915 | 0.949 | 9.430 | 0.002 | 18.445 | (2.870,118.531) | ||
WST评分 | 0.044 | 0.278 | 0.025 | 0.875 | 0.957 | (0.555,1.652) | ||
NIHSS评分 | 0.035 | 0.041 | 0.751 | 0.386 | 1.036 | (0.956,1.122) |
[1] |
《中国脑卒中防治报告2020》编写组. 《中国脑卒中防治报告2020》概要[J]. 中国脑血管病杂志,2022,19(2):136-144. DOI:10.3969/j.issn.1672-5921.2022.02.011.
|
[2] |
|
[3] |
中国卒中营养标准化管理专家委员会. 中国卒中营养标准化管理专家共识[J]. 中国卒中杂志,2020,15(6):681-689. DOI:10.3969/j.issn.1673-5765.2020.06.019.
|
[4] |
|
[5] |
中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志,2018,51(9):666-682. DOI:10.3760/cma.j.issn.1006-7876.2018.09.004.
|
[6] |
中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国脑出血诊治指南(2019)[J]. 中华神经科杂志,2019,52(12):994-1005. DOI:10.3760/cma.j.issn.1006-7876.2019.12.003.
|
[7] |
|
[8] |
|
[9] |
侯东哲,张颖,巫嘉陵,等. 中文版美国国立卫生院脑卒中量表的信度与效度研究[J]. 中华物理医学与康复杂志,2012,34(5):372-374. DOI:10.3760/cma.j.issn.0254-1424.2012.05.013.
|
[10] |
马勇. 中国城镇居民脑卒中患者医疗费用及影响因素研究[D]. 北京:北京中医药大学,2018.
|
[11] |
|
[12] |
|
[13] |
国际生命科学学会中国办事处中国肥胖问题工作组联合数据汇总分析协作组. 中国成人体质指数分类的推荐意见简介[J]. 中华预防医学杂志,2001,35(5):349-350.
|
[14] |
|
[15] |
邓晓清,黄丽华,蒋红焱,等. 急性脑卒中患者营养不良、卒中后并发症及不良预后的危险因素分析[J]. 临床神经病学杂志,2013,26(1):31-34.
|
[16] |
|
[17] |
|
[18] |
严薇,邱波,孟凡,等. 社区卫生中心住院老年脑卒中患者营养状况及影响因素研究[J]. 中国临床神经科学,2011,19(4):424-427. DOI:10.3969/j.issn.1008-0678.2011.04.020.
|
[19] |
|
[20] |
|
[21] |
窦祖林. 吞咽障碍的规范化评估与治疗中值得注意的几个问题[J]. 中国康复医学杂志,2020,35(3):257-259.
|
[22] |
|
[23] |
|
[24] |
|
[25] |
赖红宇,王留根,李和平,等. 间歇经口至食管管饲法对重型颅脑损伤患者功能恢复的影响[J]. 中华物理医学与康复杂志,2021,43(12):1117-1120.
|
[26] |
杨俊锋,陈亚男,高伟琪,等. 间歇经口至食管管饲法对脑小血管病吞咽障碍患者的影响[J]. 中华物理医学与康复杂志,2020,42(8):694-697. DOI:10.3760/cma.j.issn.0254-1424.2020.08.005.
|
[27] |
田彩红. 186例住院脑卒中患者的营养状况调查及营养风险相关因素分析[D]. 银川:宁夏医科大学,2020.
|
[28] |
杨江胜,王少石,周晓宇,等. 影响卒中后患者营养不良相关因素的研究[J]. 中华内科杂志,2009,48(12):1016-1018. DOI:10.3760/cma.j.issn.0578-1426.2009.12.010.
|
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