铁饱和度、转铁蛋白与消化性溃疡合并营养不良的相关性分析

摘要/Abstract

摘要： 目的探讨铁饱和度、转铁蛋白与消化性溃疡合并营养不良的相关性。方法选取北京市昌平区中西医结合医院2020年8月—2023年7月收治的80例消化性溃疡合并营养不良患者作为研究对象,将其设定为观察组,另选取同期来北京市昌平区中西医结合医院治疗的80例消化性溃疡未合并营养不良的患者为对照组,对比两组患者一般临床资料与铁饱和度、转铁蛋白表达水平,应用Logistic回归分析方法分析消化性溃疡合并营养不良的独立影响因素。随后将80例消化性溃疡合并营养不良患者依照身体质量指数（BMI）分为3个亚组,即BMI<16 kg/m²为重度营养不良组（n=12）,BMI 16~16.9 kg/m²为中度营养不良组（n=28）,BMI 17~18.4 kg/m²为轻度营养不良组（n=40）,对比三组患者铁饱和度、转铁蛋白表达水平,并应用Spearman相关分析方法分析铁饱和度、转铁蛋白与消化性溃疡合并营养不良严重程度的相关性。结果两组患者性别、消化性溃疡病程、幽门螺旋杆菌（Hp）检测结果、饮酒情况对比,差异无统计学意义（P>0.05）;两组患者年龄、溃疡最大直径、BMI、溃疡位置、铁饱和度、转铁蛋白水平比较,差异有统计学意义（P<0.05）。多因素logistic回归分析结果显示：年龄（OR=2.546,95%CI1.364~3.475）、BMI（OR=0.464,95%CI=0.210~1.347）、铁饱和度升高（OR=2.774,95%CI=1.876~4.010）、转铁蛋白降低（OR=0.242,95%CI=0.145~0.789）为消化性溃疡合并营养不良的独立危险因素。三组患者铁饱和度、转铁蛋白表达水平对比,差异有统计学意义（P<0.05）,且重度营养不良组铁饱和度高于中度营养不良组和轻度营养不良组,转铁蛋白低于中度营养不良组和轻度营养不良组,差异有统计学意义（P<0.05）。Spearman相关分析结果显示,铁饱和度与消化性溃疡合并营养不良严重程度呈正相关（P<0.05）,转铁蛋白与消化性溃疡合并营养不良严重程度呈负相关（P<0.05）。结论铁饱和度升高、转铁蛋白降低是消化性溃疡合并营养不良的独立影响因素,且与营养不良严重程度具有明显相关性。因此,临床对于铁饱和度升高、转铁蛋白降低的消化性溃疡患者要警惕营养不良发生,及时采取营养补充措施。

关键词: 铁饱和度, 转铁蛋白, 消化性溃疡, 营养不良, 相关性

Abstract: Objective To investigate the correlation between iron saturation, transferrin and peptic ulcer complicated with malnutrition. Methods A total of 80 patients with peptic ulcer complicated with malnutrition in our hospital from August 2020 to July 2023 were selected as the research object and divided into the observation group, and 80 patients with peptic ulcer without malnutrition in our hospital in the same period were selected as the control group. The general clinical data, iron saturation and transferrin expression levels of the two groups were compared, Logistic regression analysis was used to analyze the independent influencing factors of peptic ulcer complicated with malnutrition. Subsequently, 80 patients with peptic ulcer complicated with malnutrition were divided into three subgroups according to body mass index (BMI), namely, BMI<16 kg/m² was severe malnutrition group (n=12), BMI 16~16.9 BMI<16 kg/m² was moderate malnutrition group (n=28), BMI 17~18.4 kg/m² was mild malnutrition group (n=40). The iron saturation and transferrin expression levels of the three groups were compared, and Spearman correlation analysis method was used to analyze the iron saturation, transferrin expression level, and the iron saturation, transferrin expression level of the three groups The correlation between transferrin and the severity of peptic ulcer complicated with malnutrition. Results There were no significant differences in gender, duration of peptic ulcer, HP test results and alcohol consumption between the observation group and the control group (P>0.05). There were significant differences in age, maximum ulcer diameter, BMI, ulcer location, iron saturation and transferrin levels between the two groups (P<0.05); Logistic regression analysis showed that age, BMI, increased iron saturation and decreased transferrin were independent risk factors for peptic ulcer complicated with malnutrition (P<0.05); There were significant differences in iron saturation and transferrin expression among the three groups, and iron saturation in severe malnutrition group was higher than that in moderate malnutrition group and mild malnutrition group, while transferrin was lower than that in moderate malnutrition group and mild malnutrition group (P<0.05). Spearman correlation analysis showed that iron saturation was positively correlated with the severity of peptic ulcer complicated with malnutrition (P<0.05). Transferrin was negatively correlated with the severity of peptic ulcer complicated with malnutrition (P<0.05). Conclusion The increase of iron saturation and the decrease of transferrin are the independent influencing factors of peptic ulcer complicated with malnutrition, and have obvious correlation with the severity of malnutrition. Therefore, the clinical patients with peptic ulcer with increased iron saturation and decreased transferrin should be alert to the occurrence of malnutrition and take nutritional supplement measures in time.

Key words: iron saturation, transferrin, peptic ulcer, malnutrition, relativity

中图分类号:

R446.11

赵丽颖. 铁饱和度、转铁蛋白与消化性溃疡合并营养不良的相关性分析[J]. 中华养生保健, 2024, 42(11): 13-16.

ZHAO Li-ying. Correlation Analysis of Iron Saturation, Transferrin and Peptic Ulcer Complicated with Malnutrition[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(11): 13-16.

参考文献

[1] SAITO H, NISHIKAWA Y, MASUZAWA Y, et al.Helicobacter pylori Infection Mass Screening for Children and Adolescents: a Systematic Review of Observational Studies[J]. J Gastrointest Cancer,2021,52(2):489-497.
[2] HUSTON J M, KREINER L, HO V P, et al.Role of Empiric Anti-Fungal Therapy in the Treatment of Perforated Peptic Ulcer Disease: Review of the Evidence and Future Directions[J]. Surg Infect (Larchmt),2019,20(8):593-600.
[3] 张雪晴,荣光宏.2020年青海省消化性溃疡临床特点[J].现代消化及介入诊疗,2021,26(10):1243-1245.
[4] 王志红,赵丽菲,余爱红.儿童消化性溃疡的临床特征以及胃镜表现分析[J].临床消化病杂志,2022,34(2):79-81.
[5] 高静,杨雪,李龙心,等.全球领导人营养不良倡议(GLIM)标准在老年人群营养不良诊断中的应用[J].实用老年医学,2023,37(3):295-299.
[6] 林媛,温群,曾兰兰,等.神经外科危重病人营养风险筛查及肠内营养支持对临床结局的影响[J].现代消化及介入诊疗,2019,24(A1):645.
[7] 黄定鹏,麦维利,朱鸿武.日本胃肠病学会消化性溃疡循证临床实践指南(2020版)解读[J].大医生,2021,6(14):1-8.
[8] 许静涌,蒋朱明.2015年ESPEN营养不良(不足)诊断共识、营养风险及误区[J].中华临床营养杂志,2016,24(5):261-265.
[9] 吕昂,吴鹏波,谭诗云.合并慢性肾脏病的消化性溃疡患者的临床及胃镜下特征分析[J].医学研究杂志,2022,51(3):24-27.
[10] 王玺,糜玲.消化性溃疡Hp感染患者血清GAS,IL-33,miR-26a水平变化及与临床病理特征的关系[J].临床误诊误治,2022,35(6):84-88.
[11] 丁如梅,汤靓,范静,等.胰十二指肠切除术后营养不良的危险因素[J].肝胆胰外科杂志,2022,34(9):550-555.
[12] 张力川,王玉洁,庄冰,等.三种营养不良诊断标准在头颈部恶性肿瘤放疗病人中的应用研究[J].肠外与肠内营养,2021,28(1):25-29.
[13] 钟剑. 糖尿病肾病患者尿微量清蛋白,免疫球蛋白G,转铁蛋白和视黄醇结合蛋白的检测及其意义[J].重庆医学,2021,50(S02):198-199.
[14] 相莲,李卓,王蓓,等.缺铁性贫血患者红细胞内游离原卟啉,血浆铁和转运铁蛋白饱和度检测水平及临床意义[J].海南医学,2022,33(22):2892-2895.
[15] 路云丽,孙萍.全球领导人共识营养不良诊断标准在临床实践中的实施方法与应用[J].安徽医药,2023,27(5):1030-1036.