The Nutritional Status Of Patients With Chronic Obstructive Pulmonary Disease Stability Evaluation And The Related Clinical Factors Of Malnutrition

Objective:Using three different methods to evaluate nutritional for knowing Luzhou area patients with chronic obstructive pulmonary disease(COPD)stability of the prevalence of malnutrition,and to find out the clinical factors closely related to the nutritional status.Methods:142 cases of patients with COPD stabilization between December 2012 and December 2013 in affiliated Hospital of Luzhou Medical College,were choosed to finish the next works:① the questionnaire survey,including the patient’s symptoms,difficulty breathing survey(mMRC),COPD Assessment Test(CAT),The St George’s Hospital Respiratory Questionnaire(SGRQ),etc.②Pulmonary Function Tests,according to 2011 GOLD classification,assessment of COPD patients with symptoms and risk assessment,the patients with COPD divided into four groups:A(low risk,less symptoms),B(low risk,many symptoms),C(high risk,less symptoms),D(high risk,many symptoms).③Three nutrition evaluation methods of NRS-2002、SGA and MNA to evaluate the nutritional status in patients with COPD.④Analyze the correlation between different nutrient evaluation methods and clinical variables,and to find out the independent risk factors of malnutrition(including nutrition risk).Results:①According to the 2011 GOLD grade to evaluate patients with COPD,the results showed that the number of D group was at most,71 cases(50%),and the number of group A was at least,19 cases(13.38%);②According to the NRS-2002,SGA,MNA three methods of nutritional assessment,the incidence of malnutrition(including nutritional risk)were 79.6%,69.01%and 91.54%,respectively.③ Uni variate analysis showed that the related factors of the nutritional status were as follows:1)body mass index(BMI),passive smoking,age,FEV1、FVC,FEV1%(NRS-2002,all P<0.05);2)BMI,chronic gastritis,mMRC,CAT scores,the number of exacerbations in one year,FEV1,FEV1%,FEV1/FVC,SGRQ scores(MNA,all P<0.05);3)Passive smoking,chronic gastritis,mMRC,FEV1,SGRQ scores(SGA,all P<0.05),the common factor of three methods was FEV1.④Multiariable Logistic regression analysis showed the related factors of nutritional status were as follows:1)NRS-2002:Passive smoking(OR=8.359,P=0.019),age(OR=0.073,P<0.001);2)MNA:CAT scores(OR=0.083,P=0.018),FEV1/FVC(OR=0.090,P=0.042);3)SGA:Passive smoking(OR=10.944,P=0.001),SGRQ scores(OR=6.764,P=0.004),and these factors were independent risk factors of malnutrition.⑤The chi-square test between three groups of nutritional assessment methods and GOLD classification,MNA group was statistically different from the GOLD classification(χ2 =4.953,P=0.026);SGA group was statistically different from the GOLD classification(χ2=12.596,P=0.006);Logistic regression analysis showed that group D of SGA with respect to the group A with malnutrition OR=3.245(1.089-9.664),P=0.035.Conclusions:①According to the GOLD grade to evaluate 142 cases of patients with COPD,the results showed that the number of D group was at most.②Using three methods of NRS-2002,MNA and SGA to evaluate nutritional status of patients with COPD in Luzhou area,the incidence of malnutrition(including nutritional risk)was high.The highest incidence of malnutrition(including nutritional risk)was MNA(91.54%),and the lowest incidence of malnutrition was SGA(69.01%).③ Passive smoking,age,CAT scores,FEV1/FVC were independent risk factors for malnutrition.④Malnutrition and risk of malnutrition was frequent,we must pay attention to it.