Current status of malnutrition and its association with prognosis in hospitalized patients with decompensated liver cirrhosis
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摘要: 目的分析失代偿期肝硬化住院患者营养不良现状及其与预后的关系。方法选取郑州市中医院2013年1月-2014年12月失代偿期肝硬化患者共101例。通过营养风险筛查2002(NRS2002)将其分为营养不良风险组和非营养不良风险组。对比两组患者血清营养指标、人体测量指标、人体成分、6个月内并发症发生率和病死率。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。结果营养不良风险组的白蛋白、总胆固醇、甘油三酯、血红蛋白、BMI、上臂肌围、肱三头肌皮褶厚度和握力显著低于非营养不良风险组,差异有统计学意义(t值分别为12.562、5.967、4.024、14.775、4.607、7.182、7.424、2.256,P值均<0.05)。营养不良风险组的细胞内液、总体液量、蛋白质、脂肪和骨骼肌肉含量显著低于非营养不良风险组,差异均有统计学意义(t值分别为2.920、6.152、1.713、2.444、1.693,P值均<0.05),浮肿指数显著高于非营养不良风险组(t=1.998,P<0.05)。营养不良风险组的6个月内的消化道出血、肝性脑病、门静脉血栓形成、电解质紊乱发生率和...Abstract: Objective To investigate the current status of malnutrition and its association with prognosis in hospitalized patients with decompensated liver cirrhosis.Methods A total of 101 patients with decompensated liver cirrhosis who were treated in our department from January 2013 to December 2014 were enrolled,and according to the Nutritional Risk Screening 2002,they were divided into malnutrition risk group and non- malnutrition risk group.Serum nutritional indices,anthropometric parameters,body composition,and the incidence rates of complications and fatality within 6 months were compared between the two groups.The t- test was used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups.Results Compared with the non-malnutrition risk group,the malnutrition risk group had significantly lower serum levels of albumin,total cholesterol,triglyceride,and hemoglobin,body mass index,arm muscle circumference,triceps skinfold thickness,and grip strength(t = 12.562,5.967,4.024,14.775,4.607,7.182,7.424,and 2.256,all P < 0.05).Compared with the non- malnutrition risk group,the malnutrition risk group had significantly lower intracellular water,total body water(TBW),protein,fat,and skeletal muscle content(t = 2.920,6.152,1.713,2.444,and1.693,all P < 0.05),as well as a significantly higher extracellular water / TBW ratio(t = 1.998,P < 0.05).Compared with the non-malnutrition risk group,the malnutrition risk group had significantly higher incidence rates of gastrointestinal bleeding,hepatic encephalopathy,portal vein thrombosis,and electrolyte disturbance and fatality(χ2= 6.410,4.436,3.978,4.316,and 7.285,all P < 0.05).Conclusion Patients with decompensated liver cirrhosis and malnutrition have significantly increased incidence rates of complications and fatality,and it is necessary to enhance nutrition screening in the early stage of liver cirrhosis.
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Key words:
- liver cirrhosis /
- malnutrition /
- prognosis
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