脑卒中康复患者肥胖及膳食营养调查
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摘要
目的观测脑卒中康复患者住院期间的肥胖发生情况,评估膳食营养。方法对2015年11月至2018年6月住院的脑卒中康复患者115例进行身高、体质量、体型测定和膳食调查。将患者分为18～49岁(n=41)、50～64岁(n=54)和≥65岁(n=20)三组。结果各组超重/肥胖和腹型肥胖发生率均较高,其中超重/肥胖率三组间有显著性差异(χ~2=6.978, P <0.05),腹型肥胖率组间无显著性差异(χ~2=3.290, P> 0.05)。各组膳食中能量、碳水化物、维生素B_1、维生素B_2、维生素E、钙、钾、镁、硒实际摄入量均低于推荐量(t> 2.548, P <0.05);胆固醇、铁、磷、铜摄入量高于推荐量(t> 2.476, P <0.05)。18～49岁组和50～64岁组蛋白质和脂肪摄入量高于推荐量(t> 2.041, P <0.05);18～49岁组烟酸摄入量大于推荐量(t=2.239, P <0.05)。结论为住院脑卒中康复患者制订营养干预计划时,要保证能量合理供应,适当提高碳水化合物摄入量,降低脂肪量,注意蛋白质、钙、铁、维生素和膳食纤维等营养素的摄入。
Objective To observe the condition of obesity and dietary nutrition for stroke patients accepting rehabilitation.Methods From November, 2015 to June, 2018, 115 inpatients were investigated their height, body mass, somatotype and dietary. They were divided into 18-49 year-old group(n = 41), 50-64 year-old group(n = 54) and ≥ 65 year-old group(n = 20).Results The ratio of overweight/obesity and abdominal obesity were high in all the groups. There were significant differences in the overweight/obesity ratio among the three groups(χ~2 = 6.978, P < 0.05), but not in abdominal obesity ratio(χ~2 = 3.290, P > 0.05). Their intake of energy, carbohydrate, vitamin B_1, vitamin B_2, vitamin E, calcium, potassium, magnesium and selenium in all the groups was less than the recommendation(t > 2.548, P < 0.05), while the intake of cholesterol, iron, phosphorus and copper was more(t > 2.476, P < 0.05). The intake of protein and fat was more than the recommendation in the 18-49 year-old and the 50-64 year-old groups(t > 2.041, P < 0.05),and the intake of niacin was more than the recommendation in the 18-49 year-old group(t = 2.239, P < 0.05).Conclusion For stroke inpatients accepting rehabilitation, it is necessary to supply dietary with suitable energy, enough carbohydrate, less fat, and sufficient protein, calcium, iron, vitamin A, vitamin B_1, vitamin B_2 and dietary fiber in the diet.
Objective To observe the condition of obesity and dietary nutrition for stroke patients accepting rehabilitation.Methods From November, 2015 to June, 2018, 115 inpatients were investigated their height, body mass, somatotype and dietary. They were divided into 18-49 year-old group(n = 41), 50-64 year-old group(n = 54) and ≥ 65 year-old group(n = 20).Results The ratio of overweight/obesity and abdominal obesity were high in all the groups. There were significant differences in the overweight/obesity ratio among the three groups(χ~2 = 6.978, P < 0.05), but not in abdominal obesity ratio(χ~2 = 3.290, P > 0.05). Their intake of energy, carbohydrate, vitamin B_1, vitamin B_2, vitamin E, calcium, potassium, magnesium and selenium in all the groups was less than the recommendation(t > 2.548, P < 0.05), while the intake of cholesterol, iron, phosphorus and copper was more(t > 2.476, P < 0.05). The intake of protein and fat was more than the recommendation in the 18-49 year-old and the 50-64 year-old groups(t > 2.041, P < 0.05),and the intake of niacin was more than the recommendation in the 18-49 year-old group(t = 2.239, P < 0.05).Conclusion For stroke inpatients accepting rehabilitation, it is necessary to supply dietary with suitable energy, enough carbohydrate, less fat, and sufficient protein, calcium, iron, vitamin A, vitamin B_1, vitamin B_2 and dietary fiber in the diet.
引文
[1]王陇德,王金环,彭斌,等.?中国脑卒中防治报告2016?概要[J].中国脑血管病杂志,2017,14(4):217-224.
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[6]Pan X L.Efficacy of early rehabilitation therapy on movement ability of hemiplegic lower extremity in patients with acute cerebrovascular accident[J].Medicine(Baltimore),2018,97(2):e9544.
[7]López Espuela F,Portilla Cuenca J C,Holguín Mohedas M,et al.Nutritional status and the relationship regarding functional status after stroke[J].Nutr Hosp,2017,34(5):1353-1360.
[8]徐世海.康复科脑卒中住院患者营养不足及营养风险评估[J].世界最新医学信息文摘,2016,16(13):98.
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[10]中国营养学会.中国居民膳食营养素参考摄入量速查手册(2013版)[M].北京:中国标准出版社,2014:12-33.
[11]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-255.
[12]中国肥胖问题工作组数据汇总分析协作组.我国成人体质量指数和腰围对相关疾病危险因素异常的预测价值,适宜体质量指数和腰围切点的研究[J].中华流行病学杂志,2002,23(1):5-10.
[13]吴兆苏,霍勇,王文,等.中国高血压患者教育指南[J].中华高血压杂志,2013,6(12):78-110.
[14]陈伟,江华.2016年中国超重/肥胖医学营养治疗专家共识解读[J].中国实用内科杂志,2017,37(5):430-433.
[15]郭丽花,胡如英,龚巍巍,等.脑卒中危险因素研究进展[J].中国老年学杂志,2017,37(17):4413-4415.
[16]刘辉,左群,陈首英,等.以医院为基础的不同类型脑卒中患者危险因素分析[J].中华疾病控制杂志,2014,18(9):833-835.
[17]王静,叶冬青,汪凯.中国居民超重或肥胖、吸烟、饮酒与脑卒中关系的Meta分析[J].中华预防医学杂志,2008,42(2):115-118.
[18]吴坤.营养与食品卫生学(第5版)[M].北京:人民卫生出版社,2007:184-185.
[19]孙慧英,李涛.脑卒中及其危险因素分析[J].卒中与神经疾病,2012,19(3):167-170.
[20]张璐,杨跃进,温瑞,等.超重、肥胖和腹型肥胖与心血管代谢性疾病的关联研究[J].现代预防医学,2016,43(21):3887-3891.
[21]刘骏,麦凤娇.肥胖因素对脑卒中后偏瘫患者临床康复的影响[J].哈尔滨医药,2016,36(2):121-122.
[22]王强,孙蓉,张通,等.肥胖对脑卒中偏瘫康复的影响[J].中国康复理论与实践,2015,21(5):557-561.
[23]朱毅,朱黎婷,张燕,等.不同体重指数对卒中后功能恢复影响的分析[J].中国康复医学杂志,2012,27(8):747-749.
[24]Dai G,Du H,Wang H,et al.Preventive effect of vitamin Bsupplementation on recurrent stroke:a meta-analysis[J].Zhonghua Wei Zhong Bing Ji Jiu Yi Xue,2017,29(5):419-424.
[25]Pan W H,Lai Y H,Yeh W T,et al.Intake of potassium and magnesium-enriched salt improves functional outcome after stroke:a randomized,multicenter,double-blind controlled trial[J].Am J Clin Nutr,2017,106(5):1267-1273.
[26]孙建琴,张坚,常翠青,等.肌肉衰减综合征营养与运动干预中国专家共识(节录)[J].营养学报,2015,37(4):320-322.
[27]周芸.临床营养学[M].北京:人民卫生出版社,2017:33-34.
[2]Krishnamurthi R V,Feigin V L,Forouzanfar M H,et al.Global and regional burden of stroke during 1990-2010:findings from the Global Burden of Disease Study 2010[J].Lancet Glob Health,2013,1(5):e259-e281.
[3]国家卫生计生委脑卒中筛查与防治工程委员会.脑卒中筛查与预防技术规范[J].中国医学前沿杂志(电子版),2013,5(9):44-50.
[4]张润华,刘改芬,潘岳松,等.世界卒中流行趋势概况[J].中国卒中杂志,2014,9(9):770-771.
[5]王陇德.中国脑卒中防治报告(2017)[M].北京:人民卫生出版社,2017:1-11.
[6]Pan X L.Efficacy of early rehabilitation therapy on movement ability of hemiplegic lower extremity in patients with acute cerebrovascular accident[J].Medicine(Baltimore),2018,97(2):e9544.
[7]López Espuela F,Portilla Cuenca J C,Holguín Mohedas M,et al.Nutritional status and the relationship regarding functional status after stroke[J].Nutr Hosp,2017,34(5):1353-1360.
[8]徐世海.康复科脑卒中住院患者营养不足及营养风险评估[J].世界最新医学信息文摘,2016,16(13):98.
[9]Serra M C.The importance of assessing nutritional status to ensure optimal recovery during the chronic phase of stroke[J].Stroke Res Treat,2018,2018:1297846.
[10]中国营养学会.中国居民膳食营养素参考摄入量速查手册(2013版)[M].北京:中国标准出版社,2014:12-33.
[11]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-255.
[12]中国肥胖问题工作组数据汇总分析协作组.我国成人体质量指数和腰围对相关疾病危险因素异常的预测价值,适宜体质量指数和腰围切点的研究[J].中华流行病学杂志,2002,23(1):5-10.
[13]吴兆苏,霍勇,王文,等.中国高血压患者教育指南[J].中华高血压杂志,2013,6(12):78-110.
[14]陈伟,江华.2016年中国超重/肥胖医学营养治疗专家共识解读[J].中国实用内科杂志,2017,37(5):430-433.
[15]郭丽花,胡如英,龚巍巍,等.脑卒中危险因素研究进展[J].中国老年学杂志,2017,37(17):4413-4415.
[16]刘辉,左群,陈首英,等.以医院为基础的不同类型脑卒中患者危险因素分析[J].中华疾病控制杂志,2014,18(9):833-835.
[17]王静,叶冬青,汪凯.中国居民超重或肥胖、吸烟、饮酒与脑卒中关系的Meta分析[J].中华预防医学杂志,2008,42(2):115-118.
[18]吴坤.营养与食品卫生学(第5版)[M].北京:人民卫生出版社,2007:184-185.
[19]孙慧英,李涛.脑卒中及其危险因素分析[J].卒中与神经疾病,2012,19(3):167-170.
[20]张璐,杨跃进,温瑞,等.超重、肥胖和腹型肥胖与心血管代谢性疾病的关联研究[J].现代预防医学,2016,43(21):3887-3891.
[21]刘骏,麦凤娇.肥胖因素对脑卒中后偏瘫患者临床康复的影响[J].哈尔滨医药,2016,36(2):121-122.
[22]王强,孙蓉,张通,等.肥胖对脑卒中偏瘫康复的影响[J].中国康复理论与实践,2015,21(5):557-561.
[23]朱毅,朱黎婷,张燕,等.不同体重指数对卒中后功能恢复影响的分析[J].中国康复医学杂志,2012,27(8):747-749.
[24]Dai G,Du H,Wang H,et al.Preventive effect of vitamin Bsupplementation on recurrent stroke:a meta-analysis[J].Zhonghua Wei Zhong Bing Ji Jiu Yi Xue,2017,29(5):419-424.
[25]Pan W H,Lai Y H,Yeh W T,et al.Intake of potassium and magnesium-enriched salt improves functional outcome after stroke:a randomized,multicenter,double-blind controlled trial[J].Am J Clin Nutr,2017,106(5):1267-1273.
[26]孙建琴,张坚,常翠青,等.肌肉衰减综合征营养与运动干预中国专家共识(节录)[J].营养学报,2015,37(4):320-322.
[27]周芸.临床营养学[M].北京:人民卫生出版社,2017:33-34.