改良营养支持方案对脑梗死恢复期患者营养状况及预后的影响

郭想; 赵建军; 苏星星; 赵存喜

doi:10.16766/j.cnki.issn.1674-4152.004400

改良营养支持方案对脑梗死恢复期患者营养状况及预后的影响

doi: 10.16766/j.cnki.issn.1674-4152.004400

郭想^{1, 2},
赵建军²,
苏星星³,
赵存喜^1, ,

1.
安徽医科大学公共卫生学院，安徽合肥 230032
2.
合肥佰惠医院临床营养科，安徽合肥 230071
3.
安徽中医药大学第二附属医院脑病五科，安徽合肥 230000

基金项目:

安徽省卫健委科研课题重大项目 AHWJ2024Aa40010

详细信息

通讯作者:
赵存喜，E-mail：zhaocx1972@163.com

中图分类号: R743 R730.7
计量
- 文章访问数: 16
- HTML全文浏览量: 6
- PDF下载量: 4
- 被引次数: 0
出版历程
- 收稿日期: 2025-03-29
- 网络出版日期: 2026-06-02

The influence of improved nutritional support programs on the nutritional status and prognosis of patients in the recovery period of cerebral infarction

GUO Xiang^{1, 2},
ZHAO Jianjun²,
SU Xingxing³,
ZHAO Cunxi^{1
, ,}

1.
School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China

摘要

摘要: 目的探索营养治疗方案对脑梗死恢复期患者营养状况、日常生活活动能力、神经功能缺损、住院时间及住院费用的影响。方法采用信封法将2023年11月—2024年10月合肥佰惠医院收治的103例脑梗死恢复期患者分成3组，A组为序贯营养组(24例)，B组为常规营养组(24例)，C组为改良营养组(55例)，比较各组患者干预前和干预3周后相关指标变化，分析3种营养方案的干预效果。结果治疗后，C组营养风险筛查(NRS2002)评分[(2.69±0.86)分]显著低于A组[(3.54±0.88)分]和B组[(3.12±0.99)分, F=8.842，P＜0.001]，C组预后营养指数(PNI)、ALB、HB均显著高于A组和B组(P＜0.05)，C组CRP显著低于A组和B组(P＜0.05)。患者治疗前后比较，A组NRS2002评分显著降低，PNI、总蛋白(TP)、ALB、前白蛋白(PA)、淋巴细胞(LYM)、巴氏指数(BI)显著升高(P＜0.05)；B组NRS2002评分、CRP、卒中评分(NIHSS)显著降低，PNI评分、TP、ALB、PA、LYM、BI显著升高(P＜0.05)；C组NRS2002评分、CRP、NIHSS评分显著降低，PNI评分、TP、ALB、PA、HB、LYM、BI显著升高(P＜0.05)。C组患者住院费用最少，差异有统计学意义(P＜0.05)。结论 3种营养方案均能改善患者营养状况及预后，改良营养组方案对患者益处更多。
- 营养治疗 /
- 脑梗死恢复期 /
- 营养状况 /
- 预后
Abstract: Objective To explore the effects of different nutritional treatment regimens on the nutritional status, activities of daily living, neurological deficits, length of hospital stay, and hospitalization costs of patients in the recovery period of cerebral infarction. Methods A total of 103 patients with cerebral infarction in the recovery stage admitted to Hefei Baihui Hospital from November 2023 to October 2024 were divided into three groups by the envelope method. Group A was a sequential nutrition group (n=24), group B was a conventional nutrition group (n=24), and group C was a modified nutrition group (n=55). The changes in indicators before and after 3 weeks of intervention were collected, and the intervention effects of the three nutritional treatment regimens were compared. Results After treatment, the nutritional risk screening 2002 (NRS2002) of group C (2.69±0.86) was significantly lower than that of group A (3.54±0.88) and group B (3.12±0.99, F=8.842, P < 0.001). The prognostic nutritional index (PNI), ALB, and HB of group C were significantly higher than those of group A and group B (all P < 0.05). The CRP of group C was significantly lower than that of group A and group B (P < 0.05). Before and after treatment, the NRS2002 score of group A was significantly reduced, and the PNI, total protein (TP), ALB, prealbumin (PA), lymphocytes (LYM), and Barthel index (BI) were significantly increased (P < 0.05). The NRS2002 score, CRP, and National Institutes of Health Stroke Scale (NIHSS) score of group B were significantly reduced, and the PNI score, TP, ALB, PA, LYM, and BI were significantly increased (P < 0.05). The NRS2002, CRP, and NIHSS scores of group C were significantly reduced, and the PNI score, TP, ALB, PA, HB, LYM, and BI were significantly increased (P < 0.05). The hospitalization cost of group C was the lowest, and the difference was statistically significant (P < 0.05). Conclusion All three nutritional regimens can improve the nutritional status and prognosis of patients, and the modified nutritional regimen is more beneficial to patients.
- Nutritional therapy /
- Cerebral infarction convalescence period /
- Nutritional status /
- Prognosis

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表 1 3组脑梗死恢复期患者一般资料比较

Table 1. Comparison of general information of three groups of patients in the recovery period of cerebral infarction

项目	A组(n=24)	B组(n=24)	C组(n=55)	统计量	P值
年龄(x±s，岁)	74.58±8.46	71.79±10.75	69.91±13.10	1.359^a	0.262
性别[例(%)]				4.740^b	0.093
男性	12(50.00)	19(79.17)	32(58.18)
女性	12(50.00)	5(20.83)	23(41.82)
居住地[例(%)]				3.556^b	0.169
城市	18(75.00)	12(50.00)	37(67.27)
农村	6(25.00)	12(50.00)	18(32.73)
高血压[例(%)]				0.280^b	0.947
否	5(20.83)	4(16.67)	12(21.82)
是	19(79.17)	20(83.33)	43(78.18)
糖尿病[例(%)]				3.919^b	0.141
否	13(54.17)	16(66.67)	42(76.36)
是	11(45.83)	8(33.33)	13(23.64)
高脂血症[例(%)]				2.254^b	0.324
否	23(95.83)	21(87.50)	46(83.64)
是	1(4.17)	3(12.50)	9(16.36)
心血管疾病[例(%)]				1.984^b	0.371
否	13(54.17)	12(50.00)	36(65.45)
是	11(45.83)	12(50.00)	19(34.55)
吸烟史[例(%)]				0.611^b	0.737
否	17(70.83)	19(79.17)	43(78.18)
是	7(29.17)	5(20.83)	12(21.82)
饮酒史[例(%)]				1.731^b	0.421
否	17(70.83)	17(70.83)	45(81.82)
是	7(29.17)	7(29.17)	10(18.18)
学历[例(%)]				4.642^b	0.098
小学及以下	14(58.33)	9(37.50)	18(32.73)
初中及以上	10(41.67)	15(62.50)	37(67.27)
医保类型[例(%)]				2.928^b	0.663
居民	12(50.00)	12(50.00)	20(36.36)
职工	12(50.00)	12(50.00)	34(61.82)
自费	0	0	1(1.82)
注：^a为F值，^b为χ²值。

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表 2 3组脑梗死恢复期患者营养相关指标比较

Table 2. Comparison of nutrition-related indicators among three groups of patients in the recovery period of cerebral infarction

组别	例数	NRS2002评分(x±s，分)		PNI评分(x±s，分)		TP(x±s，g/L)		ALB(x±s，g/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组	24	4.75±0.94	3.54±0.88^bc	40.69±4.38	41.35±3.54^bc	58.21±5.84	63.27±6.58^b	34.60±4.44	35.62±4.28^bc
B组	24	4.38±1.01	3.12±0.99^bc	41.40±6.00	44.15±4.64^bc	61.23±7.21	64.26±4.81^b	34.02±4.14	37.56±3.44^bc
C组	55	4.44±0.76	2.69±0.86^b	42.45±5.67	45.27±5.61^b	60.99±6.92	62.95±5.66^b	34.97±4.07	39.05±2.38^b
统计量		1.385^a	8.842^a	0.945^a	6.604^a	1.649^a	1.333^a	0.431^a	10.947^a
P值		0.255	＜0.001	0.392	0.002	0.198	0.268	0.651	＜0.001

组别	例数	PA(x±s，mg/L)		HB(x±s，g/L)		LYM(x±s，10⁹/L)		CRP[M(P₂₅，P₇₅)，mg/L]
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组	24	146.27±42.81	185.11±41.84^b	109.92±19.45	95.96±26.31^c	1.22±0.48	1.50±0.55^b	30.53(10.85, 65.57)	18.98(8.08, 72.96)^c
B组	24	163.05±60.14	197.46±45.38^b	107.96±16.53	108.38±16.38^c	1.48±0.76	1.64±0.57^b	32.44(18.65, 70.66)	14.31(9.46, 33.04)^bc
C组	55	166.07±59.57	188.75±55.45^b	112.76±17.74	116.13±18.09^b	1.50±0.59	1.64±0.82^b	35.98(18.01, 65.51)	7.77(3.00, 12.56)^b
统计量		1.059^a	0.643^a	0.659^a	10.469^a	1.836^a	0.215^a	0.259^d	20.122^d
P值		0.351	0.528	0.520	＜0.001	0.165	0.807	0.878	＜0.001
注：^a为F值，^d为H值；与同组治疗前比较，^bP＜0.05；与C组比较，^cP＜0.05。

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表 3 3组脑梗死恢复期患者预后情况比较

Table 3. Comparison of prognosis among three groups of patients in the recovery period of cerebral infarction

组别	例数	住院时间[M(P₂₅，P₇₅)，d]	住院费用[M(P₂₅，P₇₅)，元]	BI评分[M(P₂₅，P₇₅)，分]			NHISS评分(x±s，分)
组别	例数	住院时间[M(P₂₅，P₇₅)，d]	住院费用[M(P₂₅，P₇₅)，元]	治疗前	治疗后	治疗前后差值	治疗前	治疗后
A组	24	70.00(54.00, 107.75)	70 227.50(50 560.16, 121 352.73)	0.00(0.00, 18.75)	2.50(0.00, 21.25)^b	0.00(0.00, 10.00)	22.79±10.42	22.88±12.13
B组	24	67.50(36.75, 90.50)	54 656.11(43 424.00, 114 464.42)	10.00(0.00, 20.00)	15.00(0.00, 36.25)^b	2.50(0.00, 5.00)	22.29±9.24	20.46±9.60^b
C组	55	82.00(59.00, 93.50)	46 563.30(34 353.81, 70 165.30)	5.00(0.00, 20.00)	15.00(0.00, 25.00)^b	5.00(0.00, 10.00)	24.82±9.18	22.27±9.36^b
统计量		0.798^a	6.143^a	0.851^a	0.778^a	0.973^a	0.754^c	2.869^c
P值		0.671	0.046	0.654	0.678	0.615	0.473	0.061
注：^a为H值，^c为F值；与同组治疗前比较，^bP＜0.05。

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