本文選題：老年 + 代謝綜合征�。� 參考：《承德醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:探討應(yīng)用微型營(yíng)養(yǎng)評(píng)估(miniature nutritional assessment,MNA)對(duì)老年代謝綜合征(metabolic syndrome,MS)患者的營(yíng)養(yǎng)狀況進(jìn)行評(píng)價(jià),并研究營(yíng)養(yǎng)不良的相關(guān)因素,以便為進(jìn)一步采取相應(yīng)的營(yíng)養(yǎng)教育和營(yíng)養(yǎng)治療等提供臨床依據(jù),早期改善營(yíng)養(yǎng)狀態(tài),輔助臨床治療,提倡健康的生活方式和飲食方式等,改善老年人的營(yíng)養(yǎng)狀態(tài)和生活質(zhì)量,減輕家庭和社會(huì)的負(fù)擔(dān)。方法:隨機(jī)選擇2015年3月至2016年3月期間承德醫(yī)學(xué)院附屬醫(yī)院的老年病科住院的年齡≥60歲的老年MS患者102例作為觀察組,健康老年體檢者120例作為對(duì)照組。對(duì)兩組均進(jìn)行MNA測(cè)評(píng),對(duì)兩組MNA評(píng)分進(jìn)行比較。依據(jù)MNA評(píng)分,將觀察組分為營(yíng)養(yǎng)良好組(a)、潛在營(yíng)養(yǎng)不良組(b)和營(yíng)養(yǎng)不良組(c),將對(duì)照組記錄為(d)。記錄一般臨床指標(biāo):年齡、性別、腰圍、臀圍、身高、體重,并計(jì)算腰/臀比(W/H)、體質(zhì)指數(shù)(BMI),白蛋白(ALB)、前白蛋白(PA)、淋巴細(xì)胞總數(shù)(LC)、血紅蛋白(HGB)、鈉(Na)、鉀(K)、鈣(Ca)、鎂(Mg)、磷(P)、氯(Cl)、糖化血紅蛋白(HbA1c)、總膽固醇(TC)、甘油三酯(TG)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、載脂蛋白A1(Apo-A1)、載脂蛋白B(Apo-B)、空腹血糖(Free Blood Glucose,FBG)、餐后2小時(shí)血糖(2-hour Postprandial Blood Glucose,2h PBG)(但需重復(fù)一次檢驗(yàn))、尿酸(UA)、肌酐(Cr)、尿素氮(BUN)、高敏C反應(yīng)蛋白(sCRP)等。采用SPSS19.0統(tǒng)計(jì)學(xué)軟件對(duì)數(shù)據(jù)進(jìn)行分析,計(jì)量資料以?x±s表示,資料服從正態(tài)分布,采用單因素方差分析,兩兩比較采用LSD-t檢驗(yàn);計(jì)數(shù)資料描述用例數(shù)(百分比),統(tǒng)計(jì)差異采用χ2檢驗(yàn);相關(guān)分析統(tǒng)計(jì)采用Spearman相關(guān);應(yīng)用二分類Logistic回歸分析篩選出老年MS患者營(yíng)養(yǎng)不良的相關(guān)因素。P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:1觀察組MNA營(yíng)養(yǎng)不良檢出率高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(χ2=9.404,P=0.002)。2各臨床指標(biāo)的組間比較觀察組不同營(yíng)養(yǎng)狀態(tài)患者及對(duì)照組性別構(gòu)成、BMI、W/H、高血壓病比例、TC、LDL-C、LC、上臂圍、UA、Na、K、Apo-A1、Apo-B等差異無統(tǒng)計(jì)學(xué)意義(P0.05),觀察組不同營(yíng)養(yǎng)狀態(tài)患者及對(duì)照組年齡、HGB、ALB、PA、2型糖尿病(T2-DM)、TG、HDL-C、sCRP、小腿圍、β2-MG、BUN、Cr等差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩兩比較顯示營(yíng)養(yǎng)不良組患者年齡高于其余三組,營(yíng)養(yǎng)不良風(fēng)險(xiǎn)組年齡高于營(yíng)養(yǎng)良好組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。營(yíng)養(yǎng)不良組HGB、ALB、PA低于其余三組,營(yíng)養(yǎng)不良組HGB低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。營(yíng)養(yǎng)不良組、營(yíng)養(yǎng)不良風(fēng)險(xiǎn)組HDL-C對(duì)照組。營(yíng)養(yǎng)不良組sCRP高于營(yíng)養(yǎng)不良風(fēng)險(xiǎn)組,營(yíng)養(yǎng)不良風(fēng)險(xiǎn)組高于營(yíng)養(yǎng)良好組,營(yíng)養(yǎng)良好組高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。營(yíng)養(yǎng)不良組HbA1c高于營(yíng)養(yǎng)不良風(fēng)險(xiǎn)組,營(yíng)養(yǎng)不良風(fēng)險(xiǎn)組高于營(yíng)養(yǎng)良好組及對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。營(yíng)養(yǎng)不良組糖尿病比例高于其余三組,營(yíng)養(yǎng)不良風(fēng)險(xiǎn)組亦高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。營(yíng)養(yǎng)良好組及對(duì)照組小腿圍高于其余兩組,營(yíng)養(yǎng)不良組β2-MG、BUN高于其余三組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3 Spearman相關(guān)性分析發(fā)現(xiàn)老年MS患者的MNA評(píng)分與年齡、T2-DM、sCRP、HbA1c、β2-MG、BUN等存在負(fù)相關(guān)關(guān)系(P0.05),r值分別為-0.446、-0.314、-0.374、-0.446、-0.300、-0.239;MNA評(píng)分與HGB、ALB、PA、HDL-C、小腿圍、Apo-B等存在正相關(guān)關(guān)系(P0.05),r值分別為0.318、0.525、0.339、0.279、0.309、0.219;與性別、BMI、W/H、高血壓病、TG、TC、LDL-C、LC、上臂圍、Apo-A1不存在相關(guān)關(guān)系(P0.05)。4二分類Logistic回歸分析顯示高齡、低白蛋白血癥、血清PA偏低、sCRP及HbA1c水平增高與老年MS患者營(yíng)養(yǎng)不良發(fā)生顯著相關(guān)(P0.05),OR值分別為5.622、15.092、5.919、9.591、3.776。結(jié)論:1老年代謝綜合征患者營(yíng)養(yǎng)不良發(fā)生率高于正常體檢老年人。2高齡、高敏C反應(yīng)蛋白增高及糖化血紅蛋白水平增高與老年MS患者營(yíng)養(yǎng)不良發(fā)生顯著相關(guān),可能是老年MS患者營(yíng)養(yǎng)不良的危險(xiǎn)因素。
[Abstract]:Objective: To evaluate the nutritional status of elderly metabolic syndrome (metabolic syndrome, MS) patients with miniature nutritional assessment (MNA), and to study the related factors of malnutrition in order to provide clinical basis for further nutrition education and nutrition treatment, and to improve nutritional status in early stage. To assist the clinical treatment, promote healthy lifestyle and diet, improve the nutritional status and quality of life of the elderly and reduce the burden of family and society. Methods: 102 cases of MS patients aged over 60 years of age in the Department of geriatrics in Affiliated Hospital of Chengde Medical College from March 2015 to March 2016 were selected as the observation group. 120 healthy elderly patients were treated as the control group. The two groups were evaluated by MNA, and the two groups of MNA scores were compared. According to the MNA score, the observation group was divided into good nutrition group (a), potential malnutrition group (b) and malnutrition group (c), and the control group was recorded (d). Age, sex, waist, hip, height, weight, and plan were recorded. W/H, body mass index (BMI), albumin (ALB), prealbumin (PA), total lymphocyte count (LC), hemoglobin (HGB), sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), phosphorus (P), chlorine (Cl), glycosylated hemoglobin, triglyceride, high-density lipoprotein cholesterol, low density lipoprotein cholesterol (LDL), apolipoprotein 1 (Apo-A1), apolipoprotein B (Apo-B), fasting blood glucose (Free Blood Glucose, FBG), postprandial 2 hours blood glucose (2-hour Postprandial Blood Glucose, 2h), uric acid, creatinine, urea nitrogen, Gao Min anti stress protein, etc. The data were subject to normal distribution, using single factor analysis of variance, 22 comparison using LSD-t test, counting data to describe use case number (percentage), statistical difference using chi 2 test, correlation analysis and statistical use of Spearman correlation, and using two classified Logistic regression analysis to screen out the related factors of malnutrition in old MS patients.P0.05 Results: in 1 observation group, the detection rate of malnutrition in MNA was higher than that of the control group. The difference was statistically significant (x 2=9.404, P=0.002), and there was no significant difference in sex composition, BMI, W/H, the proportion of BMI, W/H, hypertension, TC, LDL-C, LC, Na, K, K, and other groups in the group of different nutritional state and control group of.2. .05), the age of different nutritional state and control group, HGB, ALB, PA, type 2 diabetes (T2-DM), TG, HDL-C, sCRP, leg circumference, beta 2-MG, BUN, Cr were statistically significant (P0.05). 22 comparison showed that the age of dystrophy group was higher than the other three groups, and the age of dystrophy risk group was higher than that of good nutrition group, the difference was statistically significant ( P0.05). The dystrophy group HGB, ALB, PA were lower than the other three groups, and the HGB in the dystrophy group was lower than the control group, the difference was statistically significant (P0.05). The malnutrition group, the malnutrition risk group HDL-C control group. The malnutrition group sCRP was higher than the dystrophy risk group, the malnutrition risk group was higher than the good nutrition group, the good nutrition group was higher than the control group, the difference was higher than the control group, the difference was there was the difference Statistical significance (P0.05). The dystrophy group HbA1c was higher than the dystrophy risk group, the dystrophy risk group was higher than the good nutrition group and the control group, the difference was statistically significant (P0.05). The proportion of diabetes in dystrophy group was higher than the other three groups, and the dystrophy risk group was also higher than that in the control group (P0.05). The lower leg circumference of the control group was higher than that of the other two groups, and the beta 2-MG and BUN in the dystrophy group were higher than the other three groups. The difference was statistically significant (P0.05).3 Spearman correlation analysis found that the MNA score of the elderly MS patients was related to the age, T2-DM, sCRP, HbA1c, beta 2-MG, BUN, etc. The score was correlated with HGB, ALB, PA, HDL-C, calf circumference, Apo-B and so on, and R values were 0.318,0.525,0.339,0.279,0.309,0.219, and BMI, W/H, hypertension, TG, TC, hypoalbuminemia, low serum albumin, low serum albumin, low serum albumin, low serum albumin. The increase of A1c was significantly associated with malnutrition in elderly patients with MS (P0.05), and the OR value was 5.622,15.092,5.919,9.591,3.776., respectively. The incidence of malnutrition in 1 elderly patients with metabolic syndrome was higher than that of normal aged people with.2, high sensitivity C reactive protein and increased glycosylated blood erythroprotein level and malnutrition in elderly MS patients. Significant correlation may be a risk factor for malnutrition in elderly patients with MS.

【學(xué)位授予單位】：承德醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R589

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李維;季黎明;邱瓊;袁銘珊;;主觀整體評(píng)估和微型營(yíng)養(yǎng)評(píng)估在老年代謝綜合征患者營(yíng)養(yǎng)狀況評(píng)估中的運(yùn)用[J];實(shí)用老年醫(yī)學(xué);2016年07期

2 林兵;王亞非;石勱;;老年2型糖尿病患者營(yíng)養(yǎng)風(fēng)險(xiǎn)調(diào)查及其與膳食攝入、糖化血紅蛋白的關(guān)系[J];醫(yī)學(xué)研究雜志;2016年04期

3 路慧敏;沈紅藝;劉翠翠;何百勝;陳佳雯;;上海郊區(qū)某養(yǎng)老機(jī)構(gòu)老年人營(yíng)養(yǎng)不良狀況調(diào)查及影響因素分析[J];中華老年醫(yī)學(xué)雜志;2015年10期

4 石漢平;趙青川;王昆華;許紅霞;李薇;方玉;余時(shí)滄;齊玉梅;朱廣迎;路潛;羅琪;張曉偉;譚榮紹;焦廣宇;賈潤(rùn)萍;周莉;葛聲;叢明華;李增寧;王昆;張小田;于康;劉英華;周云;謝叢華;崔久嵬;管文賢;施萬英;胡雯;趙長(zhǎng)海;陳偉;朱翠鳳;李蘇宜;高鳳莉;巴一;陳子華;林源;曹偉新;陳公琰;;營(yíng)養(yǎng)不良的三級(jí)診斷[J];腫瘤代謝與營(yíng)養(yǎng)電子雜志;2015年02期

5 楊國(guó)莉;趙喜蘭;黎明;;微型營(yíng)養(yǎng)評(píng)價(jià)法在老年心血管疾病住院患者營(yíng)養(yǎng)不良風(fēng)險(xiǎn)評(píng)價(jià)中的應(yīng)用[J];重慶醫(yī)學(xué);2015年10期

6 李惠萌;史文麗;馬向麗;;NRS2002和SGA在不同體質(zhì)指數(shù)2型糖尿病患者中的應(yīng)用研究[J];實(shí)用預(yù)防醫(yī)學(xué);2014年12期

7 李婷;沈靜;吳紅梅;;營(yíng)養(yǎng)風(fēng)險(xiǎn)篩查和微型營(yíng)養(yǎng)評(píng)定用于高齡糖尿病患者營(yíng)養(yǎng)評(píng)估的比較[J];中國(guó)煤炭工業(yè)醫(yī)學(xué)雜志;2014年09期

8 王秋梅;陳偉;宋長(zhǎng)城;張悅;李巍;朱鳴雷;劉曉紅;;MNA和NRS2002對(duì)老年住院患者營(yíng)養(yǎng)評(píng)估的比較[J];中華老年多器官疾病雜志;2014年07期

9 李纓;陳彪;關(guān)紹晨;張錦;;北京社區(qū)老年人營(yíng)養(yǎng)狀況及相關(guān)因素[J];中國(guó)老年學(xué)雜志;2012年20期

10 張潔;陳雅萍;趙鳴;鐘節(jié)鳴;何青芳;王立新;龔巍巍;俞敏;;浙江農(nóng)村35歲以上人群代謝綜合征患病率調(diào)查[J];中國(guó)農(nóng)村衛(wèi)生事業(yè)管理;2010年08期

相關(guān)碩士學(xué)位論文 前1條

1 舒畫;人體成分與營(yíng)養(yǎng)元素分析及其與代謝綜合征的關(guān)系[D];中國(guó)人民解放軍醫(yī)學(xué)院;2013年

，

本文編號(hào)：1787866