支气管扩张症患者存在营养风险的危险因素分析
Risk Factors Analysis for Nutritional Risk in Patients with Bronchiectasis
DOI: 10.12677/acm.2025.154957, PDF,    科研立项经费支持
作者: 曹雪霜, 舒国庆：安徽医科大学第一附属医院全科医学科，安徽 合肥；柯张延, 姜雪勤, 徐玉菲, 范晓云*：安徽医科大学第一附属医院老年呼吸与危重症医学科，安徽 合肥
关键词: 营养风险；高分辨胸部CT成像；FVC；FEV1；Reiff评分；Nutritional Risk； High Resolution Chest CT Imaging； FVC； FEV1； Reiff Score
摘要: 目的：探寻支气管扩张症(BE)患者存在营养风险的危险因素，以减少其发生，改善BE患者生活质量及预后。方法：本研究纳入126例BE患者，依据NRS-2002分为有营养风险组与无营养风险组。收集患者一般基线资料、检查及检验结果，符合正态分布采用均数独立样本t检验，偏态分布采用Mann-Whitney U检验，计数资料采用x2检验并绘制受试者工作特征(ROC)曲线评估Reiff评分对支扩患者存在营养风险的预测价值。结果：有营养风险组相较无营养风险组，Reiff评分升高，用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、白蛋白、白蛋白与球蛋白比值、血清钠离子水平均减低。结论：Reiff评分升高、FVC和FEV1减低、白蛋白及白蛋白与球蛋白比值减低、血清钠离子减低的患者更易存在营养风险。Reiff评分作为支扩患者存在营养风险的早期预测指标具有一定参考意义。
Abstract: Objective: To explore the risk factors of nutritional risk in patients with acute exacerbation of bronchiectasis (BE), in order to reduce the occurrence of nutritional risk and improve the quality of life and prognosis of BE patients. Methods: A total of 126 patients with BE were enrolled in this study and divided into nutritional risk group and non-nutritional risk group according to NRS-2002. Independent sample, t test was used for normal distribution, Mann-Whitney U test was used for skewed distribution, x2 test was used for count data, and receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of Reiff score for nutritional risk in patients with bronchiectasis. Results: The Reiff score of the nutritional risk group was higher than that of the non-nutritional risk group, and the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), albumin, albumin to globulin ratio, and serum sodium ion levels were lower. Conclusion: Patients with increased Reiff score, decreased FVC and FEV1, decreased albumin and albumin to globulin ratio, and decreased serum sodium are more likely to have nutritional risk. Reiff score has a certain predictive value for early detection of nutritional risk in patients with BE.
文章引用：曹雪霜, 柯张延, 舒国庆, 姜雪勤, 徐玉菲, 范晓云. 支气管扩张症患者存在营养风险的危险因素分析[J]. 临床医学进展, 2025, 15(4): 483-491. https://doi.org/10.12677/acm.2025.154957

参考文献

[1] 支气管扩张症专家共识撰写协作组, 中华医学会呼吸病学分会感染学组. 中国成人支气管扩张症诊断与治疗专家共识[J]. 中华结核和呼吸杂志, 2021, 44(4): 311-321.
[2] O’Donnell, A.E. (2018) Bronchiectasis Update. Current Opinion in Infectious Diseases, 31, 194-198. [Google Scholar] [CrossRef] [PubMed]
[3] Quint, J.K., Millett, E.R.C., Joshi, M., Navaratnam, V., Thomas, S.L., Hurst, J.R., et al. (2015) Changes in the Incidence, Prevalence and Mortality of Bronchiectasis in the UK from 2004 to 2013: A Population-Based Cohort Study. European Respiratory Journal, 47, 186-193. [Google Scholar] [CrossRef] [PubMed]
[4] Goeminne, P.C., Nawrot, T.S., Ruttens, D., Seys, S. and Dupont, L.J. (2014) Mortality in Non-Cystic Fibrosis Bronchiectasis: A Prospective Cohort Analysis. Respiratory Medicine, 108, 287-296. [Google Scholar] [CrossRef] [PubMed]
[5] Lin, J., Xu, J. and Qu, J. (2016) Bronchiectasis in China. Annals of the American Thoracic Society, 13, 609-616. [Google Scholar] [CrossRef] [PubMed]
[6] Flume, P.A., Chalmers, J.D. and Olivier, K.N. (2018) Advances in Bronchiectasis: Endotyping, Genetics, Microbiome, and Disease Heterogeneity. The Lancet, 392, 880-890. [Google Scholar] [CrossRef] [PubMed]
[7] Shi, R., Wang, X., Lu, X., Zhu, Z., Xu, Q., Wang, H., et al. (2020) A Systematic Review of the Clinical and Genetic Characteristics of Chinese Patients with Cystic Fibrosis. Pediatric Pulmonology, 55, 3005-3011. [Google Scholar] [CrossRef] [PubMed]
[8] Calañas-Continente, A., Gutiérrez-Botella, J., García-Currás, J., Cobos, M.J., Vaquero, J.M., Herrera, A., et al. (2024) Global Leadership Initiative on Malnutrition-Diagnosed Malnutrition in Lung Transplant Candidates. Nutrients, 16, Article 376. [Google Scholar] [CrossRef] [PubMed]
[9] Wang, N., Qu, J. and Xu, J. (2018) Bronchiectasis Management in China, What We Can Learn from European Respiratory Society Guidelines. Chinese Medical Journal, 131, 1891-1893. [Google Scholar] [CrossRef] [PubMed]
[10] Derbyshire, E.J. and Calder, P.C. (2021) Bronchiectasis—Could Immunonutrition Have a Role to Play in Future Management? Frontiers in Nutrition, 8, Article 652410. [Google Scholar] [CrossRef] [PubMed]
[11] 黄平, 李玉红, 刘汉芸, 等. 预后营养指数与支气管扩张急性期患者疾病严重程度的相关性[J]. 医学研究生学报, 2021, 34(11): 1167-1170.
[12] Choi, H., Xu, J., Chotirmall, S.H., Chalmers, J.D., Morgan, L.C. and Dhar, R. (2024) Bronchiectasis in Asia: A Review of Current Status and Challenges. European Respiratory Review, 33, Article 240096. [Google Scholar] [CrossRef] [PubMed]
[13] Martínez-García, M.Á., Máiz, L., Olveira, C., Girón, R.M., de la Rosa, D., Blanco, M., et al. (2018) Normativa sobre el tratamiento de las bronquiectasias en el adulto. Archivos de Bronconeumología, 54, 88-98. [Google Scholar] [CrossRef] [PubMed]
[14] Wahyuni, D., Taslim, N., Syam, N. and Virani, D. (2021) Medical Nutritional Therapy in Infected Bronchiectasis with Impending Respiratory Failure: A Case Report. Gaceta Sanitaria, 35, S515-S518. [Google Scholar] [CrossRef] [PubMed]
[15] Li, L., Li, Z., Bi, J., Li, H., Wang, S., Shao, C., et al. (2020) The Association between Serum Albumin/Prealbumin Level and Disease Severity in Non‐CF Bronchiectasis. Clinical and Experimental Pharmacology and Physiology, 47, 1537-1544. [Google Scholar] [CrossRef] [PubMed]
[16] 赵明, 王玉彩. 支气管扩张患者营养风险与疾病严重程度相关性研究[J]. 实用临床医药杂志, 2019, 23(3): 60-62, 66.
[17] Guz-Mark, A. and Shamir, R. (2023) Nutrition and Chronic Diseases. In: Shamir, R., Koletzko, B., Phillip, M. and Turck, D., Eds., World Review of Nutrition and Dietetics, S. Karger AG, 128-139. [Google Scholar] [CrossRef] [PubMed]
[18] Cass, A.R. and Charlton, K.E. (2022) Prevalence of Hospital‐Acquired Malnutrition and Modifiable Determinants of Nutritional Deterioration during Inpatient Admissions: A Systematic Review of the Evidence. Journal of Human Nutrition and Dietetics, 35, 1043-1058. [Google Scholar] [CrossRef] [PubMed]
[19] Davis, S.D., Rosenfeld, M., Lee, H., Ferkol, T.W., Sagel, S.D., Dell, S.D., et al. (2019) Primary Ciliary Dyskinesia: Longitudinal Study of Lung Disease by Ultrastructure Defect and Genotype. American Journal of Respiratory and Critical Care Medicine, 199, 190-198. [Google Scholar] [CrossRef] [PubMed]
[20] Perea, L., Bottier, M., Cant, E., Richardson, H., Dicker, A.J., Shuttleworth, M., et al. (2024) Airway Il-1β Is Related to Disease Severity and Mucociliary Function in Bronchiectasis. European Respiratory Journal, 64, Article 2301966. [Google Scholar] [CrossRef] [PubMed]
[21] Chen, X., Hu, S., Jia, X. and Zeng, B. (2024) Incremental Load Respiratory Muscle Training Improves Respiratory Muscle Strength and Pulmonary Function in Children with Bronchiectasis. Canadian Respiratory Journal, 2024, Article ID: 8884030. [Google Scholar] [CrossRef] [PubMed]
[22] Gea, J., Sancho-Muñoz, A. and Chalela, R. (2018) Nutritional Status and Muscle Dysfunction in Chronic Respiratory Diseases: Stable Phase versus Acute Exacerbations. Journal of Thoracic Disease, 10, S1332-S1354. [Google Scholar] [CrossRef] [PubMed]
[23] Cheng, W., Chang, C., Sheu, C., Wang, P., Hsieh, M., Chen, M., et al. (2024) Correlating Reiff Scores with Clinical, Functional, and Prognostic Factors: Characterizing Noncystic Fibrosis Bronchiectasis Severity. European Journal of Medical Research, 29, Article No. 286. [Google Scholar] [CrossRef] [PubMed]
[24] Mills, D.R., Masters, I.B., Yerkovich, S.T., McEniery, J., Kapur, N., Chang, A.B., et al. (2024) Radiographic Outcomes in Pediatric Bronchiectasis and Factors Associated with Reversibility. American Journal of Respiratory and Critical Care Medicine, 210, 97-107. [Google Scholar] [CrossRef] [PubMed]
[25] Schuetz, P., Seres, D., Lobo, D.N., Gomes, F., Kaegi-Braun, N. and Stanga, Z. (2021) Management of Disease-Related Malnutrition for Patients Being Treated in Hospital. The Lancet, 398, 1927-1938. [Google Scholar] [CrossRef] [PubMed]
[26] Ringshausen, F.C., Shapiro, A.J., Nielsen, K.G., Mazurek, H., Pifferi, M., Donn, K.H., et al. (2024) Safety and Efficacy of the Epithelial Sodium Channel Blocker Idrevloride in People with Primary Ciliary Dyskinesia (CLEAN-PCD): A Multinational, Phase 2, Randomised, Double-Blind, Placebo-Controlled Crossover Trial. The Lancet Respiratory Medicine, 12, 21-33. [Google Scholar] [CrossRef] [PubMed]

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