Nutritional Status Survey Of Aplastic Anemia Patients

Aplastic anemia?AA?consists of a series of clinical syndromes of pancytopenia that are caused by bone marrow failure due to various reasons;it can occur in all age groups.The blood hemoglobin indicator of AA patients is less than the minimum value for a normal population of the same age and sex,which causes reduced oxygen-carrying capacity and affects the proper functioning of various body systems.At the beginning of medical treatment,most patients exhibit varying degrees of loss of appetite,bloating,nausea and other symptoms,and many patients may experience significant weight loss.Nutritional deficiency conditions caused by AA disease,such as increased consumption and decomposition of muscle cells and reduced appetite,should be seriously examined.Although articles on the investigation of clinical nutritional status have received more and more attention,articles on the nutritional status of people with aplastic anemia have not yet been reported.Objective1.To analyze the nutritional status of aplastic anemia patients.2.To explore the individualized nutritional assessment content of patients with aplastic anemia to provide a theoretical basis for formulating nutritional interventions for patients with hematological diseases.Methods1.All cases involved AA patients who were treated in Anemia Diagnosis and Treatment Center of Blood Diseases Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College from January 2016 to January 2017.Patients were screened for nutritional status using the NRS2002 scale,and a preliminary assessment was made on the nutritional status of the patients?risk of malnutrition/malnutrition?based on the results of the screening.2.Using the current survey methods,622 patients were selected from the group of patients with“malnutrition/risk of malnutrition”.Collect general patient information,demographic information,and disease-related information including height,weight,gender,age,and area of residence.At the same time,record the patient's hematology test indicators,include body mass index?BMI?,hemoglobin?Hb?,serum total protein?TP?,serum albumin(Serum albumin?Alb?,Folic acid?FA?,Vitamin B₁₂(VitaminB₁₂,VitB₁₂),Serum iron?SI?,Serum ferritin?SF?,Unsaturated iron binding capacity?UIBC?and transferrin saturation?TS?.Through the comparison among different groups,the differences among the groups in the nutritional testing indicators were studied.Results1.Total of 879 aplastic anemia patients admission to the hospital were screened using the NRS2002 scale,of which 257 were non-malnutrition?total score<3 points?,accounting for 29.2%of the total;there was a risk of malnutrition?total score?3points?622 patients,accounting for 70.8%of the total.2.According to the screening results of the scale,patients with malnutrition/risk are further studied and these patients are grouped according to gender,age,living area,disease diagnosis,and hemoglobin indicators.Among these patients,the BMIs of non-severe AA?NSAA?patients were higher than the BMIs of severe AA?SAA?patients?P<0.05?.The serum protein levels?TP and Alb?differed between the severe AA?SAA?group and the NSAA group,and lower hemoglobin?Hb?was correlated with lower serum Alb concentration?P<0.01?.The concentration of B vitamins(FA and VitB₁₂)significantly differed between urban patients and rural patients?P<0.01?,with severe deficiency in rural patients?P<0.01?.The iron metabolism indicators?SI,SF,UIBC,and TS?showed statistically significant differences?P<0.05?between the SAA group and the NSAA group.Among the 97 cases of iron overload?15.6%of the entire patient group?,the iron overload rate of the SAA group?19.1%?was much higher than that of the NSAA group?8.1%?.ConclusionsNRS-2002 nutritional risk screening scale can understand the current nutritional status of patients,but it can not fully reflect the nutritional status of patients with hematological diseases,clinical assessment should be combined with AA patients hematology test indicators to make a comprehensive assessment.AA patients who were admitted to the hospital exhibited malnutrition conditions,such as protein deficiency,B vitamin deficiency,and increased metabolic load of the trace element iron.For AA patients admitted to hospital,we must not only give assessment of nutritional status,but also individualized nutritional care combined with the professional characteristics of patients with hematopathy,in particularly,we must pay attention to disease classification and hemoglobin fluctuations,and pay attention to the geographical location of patients in urban and rural areas.Giving a comprehensive assessment of the condition and nutritional status,thus providing a theoretical basis for us to formulate characteristic nutritional interventions for patients with hematological diseases.