目的 探讨老年营养风险指数(GNRI)与慢性阻塞性肺疾病者急性加重期患者预后的相关性。方法 选择贵州省六盘水水旷医院2019年1月—2022年1月收治的COPD急性加重期患者,根据GNRI值,分为正常营养组(GNRI>98)和营养不良组(GNRI≤98),应用生存曲线和Cox比例风险回归评估营养状况与死亡率之间的关联。结果 共纳入198例COPD急性加重期患者,正常营养组90例,营养不良组108例,营养不良发生率为54.5%;Kaplan-Meier曲线表明,营养不良组的全因累积死亡率更高(58.3% vs 35.0%,P<0.001)。Cox比例风险回归分析显示在未校正模型中,HR为2.31(1.25~4.28),P<0.001。在完全校正模型中,HR为2.48(1.37~4.51),P=0.005,提示与正常营养状况相比,营养不良与全因死亡风险升高相关。结论 GNRI低是COPD患者急性加重期全因死亡的独立危险因素。
Objective To investigate the correlation between elderly nutritional risk index(GNRI)and prognosis of patients with AECOPD.Methods Patients with AECOPD admitted to our hospital from January 2019 to January 2022 were selected and divided into normal nutrition group(GNRI>98)and malnutrition group(GNRI≤98)according to GNRI value.Survival curve and Cox regression were used to evaluate the association between nutritional status and mortality.Results A total of 198 patients with AECOPD were included in this study.According to GNRI scores,90 patients were in the normal nutrition group and 108 were in the malnutrition group,with malnutrition incidence of 54.5%.The Kaplan-Meier curve showed that the cumulative all-cause mortality was higher in the malnutrition group(58.3% vs 35%,P<0.001).Cox proportional hazard regression analysis showed that HR in the uncorrected model was 2.31(1.25-4.28),P<0.001.In the fully corrected model,HR was 2.4(1.37-4.51)and P=0.005,suggesting that malnutrition was associated with a significantly higher risk of all-cause mortalitycompared with normal nutritional status.Conclusions Low GNRI is an independent risk factor for all-cause death in AECOPD patients.