克罗恩病住院患者营养风险与临床特征的关联分析

发布时间：2019-04-04 20:23

【摘要】：背景克罗恩病(crohn’s disease,CD)是发生在消化系统的原因不明的慢性复发性炎症性疾病。由于该疾病本身特点及长期反复炎症引起的并发症,常常导致营养不良的发生。因此,对CD患者进行营养风险筛查,早期进行营养干预,改善患者的全身以及肠道局部营养状况是CD治疗及康复的重要环节。目的探讨CD住院患者营养风险与临床特征的关联。方法采用营养风险筛查2002(Nutritional risk screening,NRS 2002)方法,对上海市第十人民医院消化内科2014年1月1日至2015年4月30日280例住院确诊为CD的患者进行营养风险筛查。并收集患者住院号、入院日期、姓名、性别、年龄、身高、体重、BMI、48h内生化指标(WBC、PLT、HB、HCT、CRP、ESR)、内镜评分(SES-CD)、蒙特利尔分型、疾病活动度、病程及手术史。根据性别将其分为男性、女性,根据CD活动指数(Crohn's disease activity index,CDAI)将其分为临床缓解期、轻度活动期、中度活动期和重度活动期,根据蒙特利尔分型将其按照诊断年龄、病变部位、疾病行为、肛周病变分别进行分组,根据有无肠道手术史将其分为有手术史组、无手术史组。采用两独立样本χ2检验对比各组间营养风险发生率的差异;采用两独立样本T检验分析有营养风险组和无营养风险组临床指标之间的差异。结果280例CD住院患者中,有125例存在营养风险,营养风险发生率为44.6%(125/280)。在这些患者中,不同性别、不同病变部位、不同临床分期营养风险的发生率不同,差异有统计学意义(P0.05);不同年龄、是否肛周病变、是否有肠道手术史、不同疾病行为营养风险的发生率相同,差异无统计学意义(P0.05)。BMI、HB、HCT、白蛋白、PLT为营养风险发生的危险因素。其差异有统计学意义(P0.05);其余各指标之间差异无统计学意义(P0.05)。结论1.通过筛查发现CD住院患者营养风险发生率较高;2.不同性别、不同病变部位、不同临床分期营养风险的发生率不同;3.BMI、HB、HCT、白蛋白、PLT对预测CD病人营养风险的发生有一定的意义。
[Abstract]:Background Crohn's disease (crohn's disease,CD) is a chronic recurrent inflammatory disease with unknown causes in the digestive system. Because of the characteristics of the disease and long-term recurrent inflammation caused by complications, often lead to malnutrition. Therefore, nutritional risk screening, early nutritional intervention and improvement of general and local nutritional status of patients with CD are important links in the treatment and rehabilitation of CD. Objective to investigate the relationship between nutritional risk and clinical characteristics in patients with CD. Methods Nutrition risk screening (2002 (Nutritional risk screening,NRS 2002) was used to screen the nutritional risk of 2002 patients diagnosed as CD in the Department of Gastroenterology of the 10th people's Hospital of Shanghai from January 1, 2014 to April 30, 2015. The patients' hospitalization number, date of admission, name, sex, age, height, weight, BMI,48h internal biochemical index (WBC,PLT,HB,HCT,CRP,ESR), endoscopy score (SES-CD), Montreal classification, disease activity were collected. Course of disease and history of operation. According to sex, it was classified as male and female, and according to CD activity index (Crohn's disease activity index,CDAI), it was classified as clinical remission, mild active, moderate active and severe active, according to Montreal classification according to their diagnostic age. The lesion site, disease behavior and perianal lesion were divided into two groups according to the history of intestinal surgery, and divided into two groups: operation group and non-operation history group. Two independent samples 蠂 2 test was used to compare the incidence of nutritional risk among the three groups, and two independent samples T test was used to analyze the difference of clinical indexes between the group with nutrition risk and the group without nutrition risk. Results of the 280 inpatients with CD, 125 had nutritional risk, and the incidence of nutritional risk was 44.6% (125 / 280). In these patients, different gender, different lesion location, different clinical stages of nutritional risk rate is different, the difference is statistically significant (P0.05); BMI, HB,HCT, albumin and PLT were the risk factors of nutritional risk in different age, whether there was perianal lesion, whether there was history of intestinal surgery, and the incidence of nutritional risk of different diseases was the same (P0.05). The difference was statistically significant (P0.05); there was no significant difference between the other indicators (P0.05). Conclusion 1. Through screening, it was found that the incidence of nutritional risk in CD inpatients was higher; 2. The incidence of nutritional risk was different in different sex, different lesion location and different clinical stages. 3. BMI, HB, HCT, albumin and PLT had certain significance in predicting the occurrence of nutritional risk in patients with CD.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R574.62;R459.3

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