山东临沂市老年肺结核患者膳食与营养状况分析
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摘要
目的了解老年肺结核患者膳食与营养状况,为有效地改善其营养不良提供科学依据。方法采用病例对照研究,于2013年至2017年在山东省临沂市某医院和四个结核病防治所随机选取60岁以上的1795位老年肺结核患者,并在当地(或同一社区或村组)随机选择1146位正常老年人作为正常对照。收集研究对象的个人基本信息、身高、体重等指标,并计算BMI,进行营养状况评价;采用连续3d24h膳食回顾法对其开展膳食摄入情况调查;计算其能量及各种营养素摄入量。结果老年肺结核组能量、蛋白质、K、Ca、Zn、Se、维生素A、维生素B1、维生素C等营养素的摄入水平未达到中国居民膳食营养素参考摄入量(DRIs)。其中老年肺结核组蛋白质和锌的摄入量为(56.91 g/d和8.43 mg/d)均明显低于正常老年组人群(61.33 g/d和9.05 mg/d),老年肺结核组营养不良率达到27.7%,显著高于健康老年人群(15.6%)。结论老年肺结核患者蛋白质和锌等营养素摄入不足,营养不良较为严重。因此,应加强老年肺结核患者营养监测与评价,及时有效地改善其营养状况。[营养学报,2019,41(2):135-138]
Objective To investigate the nutritional status and food intake of elderly patients with pulmonary tuberculosis(PTB), so as to provide scientific basis for improving their malnutrition efficiently. Methods A case-control study was conducted in which 1795 elderly patients aged over 60 years with pulmonary tuberculosis were randomly selected in a hospital and four TB control centers in Linyi City, Shandong Province during 2013 to 2017. Meanwhile, 1146 health elderly were selected randomly as normal control in the same community or village group. The basic information such as height, weight was collected and BMI was calculated and evaluated. The 24-hour dietary recall survey for 3 consecutive days was carried out and analyzed for energy and nutrient intakes. Results The intake levels of energy, protein, K, Ca, Zn, Se,vitamin A, vitamin B1, vitamin C and other nutrients in the elderly pulmonary tuberculosis group were lower then Chinese dietary reference intakes(DRIs). The intake was significantly lower for protein(56.91 g/d) and zinc(8.43 mg/d) in the elderly pulmonary tuberculosis patients than that in the normal elderly(61.33 g/d, 9.05 mg/d)(P< 0.05). The rate of malnutrition was significantly higher in elderly pulmonary tuberculosis patients(27.7%), than that in the healthy elderly population(15.6%). Conclusion The protein and zinc intakes are insufficient obviously in elderly patients with PTB. The prevalence of malnutrition is higher in the elderly with pulmonary tuberculosis. Therefore, nutritional surveillance should be needed among the elderly with pulmonary tuberculosis, in order to improve their nutrition status timely and effectively.[ACTA NUTRIMENTA SINICA, 2019, 41(2):135-138]
Objective To investigate the nutritional status and food intake of elderly patients with pulmonary tuberculosis(PTB), so as to provide scientific basis for improving their malnutrition efficiently. Methods A case-control study was conducted in which 1795 elderly patients aged over 60 years with pulmonary tuberculosis were randomly selected in a hospital and four TB control centers in Linyi City, Shandong Province during 2013 to 2017. Meanwhile, 1146 health elderly were selected randomly as normal control in the same community or village group. The basic information such as height, weight was collected and BMI was calculated and evaluated. The 24-hour dietary recall survey for 3 consecutive days was carried out and analyzed for energy and nutrient intakes. Results The intake levels of energy, protein, K, Ca, Zn, Se,vitamin A, vitamin B1, vitamin C and other nutrients in the elderly pulmonary tuberculosis group were lower then Chinese dietary reference intakes(DRIs). The intake was significantly lower for protein(56.91 g/d) and zinc(8.43 mg/d) in the elderly pulmonary tuberculosis patients than that in the normal elderly(61.33 g/d, 9.05 mg/d)(P< 0.05). The rate of malnutrition was significantly higher in elderly pulmonary tuberculosis patients(27.7%), than that in the healthy elderly population(15.6%). Conclusion The protein and zinc intakes are insufficient obviously in elderly patients with PTB. The prevalence of malnutrition is higher in the elderly with pulmonary tuberculosis. Therefore, nutritional surveillance should be needed among the elderly with pulmonary tuberculosis, in order to improve their nutrition status timely and effectively.[ACTA NUTRIMENTA SINICA, 2019, 41(2):135-138]
引文
[1]World Health Organization.Global Tuberculosis Report2018.WHO;Geneva,Switzerland:2018.Available online:https://www.who.int/tb/publications/global_report/en/
[2]Gavazzi G,Herrmann F,Krause KH,Aging and infectious diseases in the developing world[J].Clin Infect Dis,2004,39:83-91.
[3]全国第五次结核病流行病学抽样调查技术指导组.2010年全国第五次结核病流行病学抽样调查报告[J].中国防痨杂志,2012,34:485-508.
[4]卫生部疾病预防控制局.中国结核病防治规划实施工作指南[M].2008年版.北京:中国协和医科大学出版社,2009:12-23.
[5]程义勇.《中国居民膳食营养素参考摄入量》2013修订版简介[J].营养学报,2014,36:313-317
[6]孙红卫,吕春燕,祁爱琴,等.综合评价中数据标准化的原理研究[J].中国卫生统计,2015,32:342-344.
[7]王瑛琨.结核病患者膳食多样化及营养素摄入情况调查分析[J].中国食物与营养,2011,17:73-77.
[8]宋雨倬,马文浩,成瑶,等.甘肃地区肺结核合并糖尿病患者膳食营养分析[J].中国全科医学,2012,15:3541-3543,3547.
[9]马皎洁,安军,贺红,等.结核病患者营养状况及营养支持研究进展[J].中国防痨杂志,2016,38:995-999.
[10]谭守勇,谢灿茂.营养不良与结核病的发病和治疗[J].中国防痨杂志,2004,26:110-113.
[11]Koethe JR,von Reyn CF.Protein-calorie malnutrition,macronutrient supplements,and tuberculosis[J].Int JTuberc Lung Dis,2016,20:857-863.
[12]Mupere E,Malone L,Zalwango S.Lean tissue mass wasting is associated with increased risk of mortality among women with pulmonary tuberculosis in urban Uganda[J].Ann Epidemiol,2012,22:466-473.
[13]温新宇.什么是微量元素?微量元素有什么作用?[J].中华检验医学杂志,2007,30:871-871.
[14]景洪江,刘英华,王觐,等.补充微量营养素对2型糖尿病患者免疫功能和感染的影响[J].营养学报,2010,32:11-16.
[15]王雅,李传友,王伟,等.巨噬细胞在抗结核感染中的作用[J].中国防痨杂志,2018,40:218-221.
[16]谭守勇,陈洪光,关玉华,等.营养辅助治疗复治菌阳肺结核[J].临床肺科杂志,2005,10:147-150.
[2]Gavazzi G,Herrmann F,Krause KH,Aging and infectious diseases in the developing world[J].Clin Infect Dis,2004,39:83-91.
[3]全国第五次结核病流行病学抽样调查技术指导组.2010年全国第五次结核病流行病学抽样调查报告[J].中国防痨杂志,2012,34:485-508.
[4]卫生部疾病预防控制局.中国结核病防治规划实施工作指南[M].2008年版.北京:中国协和医科大学出版社,2009:12-23.
[5]程义勇.《中国居民膳食营养素参考摄入量》2013修订版简介[J].营养学报,2014,36:313-317
[6]孙红卫,吕春燕,祁爱琴,等.综合评价中数据标准化的原理研究[J].中国卫生统计,2015,32:342-344.
[7]王瑛琨.结核病患者膳食多样化及营养素摄入情况调查分析[J].中国食物与营养,2011,17:73-77.
[8]宋雨倬,马文浩,成瑶,等.甘肃地区肺结核合并糖尿病患者膳食营养分析[J].中国全科医学,2012,15:3541-3543,3547.
[9]马皎洁,安军,贺红,等.结核病患者营养状况及营养支持研究进展[J].中国防痨杂志,2016,38:995-999.
[10]谭守勇,谢灿茂.营养不良与结核病的发病和治疗[J].中国防痨杂志,2004,26:110-113.
[11]Koethe JR,von Reyn CF.Protein-calorie malnutrition,macronutrient supplements,and tuberculosis[J].Int JTuberc Lung Dis,2016,20:857-863.
[12]Mupere E,Malone L,Zalwango S.Lean tissue mass wasting is associated with increased risk of mortality among women with pulmonary tuberculosis in urban Uganda[J].Ann Epidemiol,2012,22:466-473.
[13]温新宇.什么是微量元素?微量元素有什么作用?[J].中华检验医学杂志,2007,30:871-871.
[14]景洪江,刘英华,王觐,等.补充微量营养素对2型糖尿病患者免疫功能和感染的影响[J].营养学报,2010,32:11-16.
[15]王雅,李传友,王伟,等.巨噬细胞在抗结核感染中的作用[J].中国防痨杂志,2018,40:218-221.
[16]谭守勇,陈洪光,关玉华,等.营养辅助治疗复治菌阳肺结核[J].临床肺科杂志,2005,10:147-150.