【作者】 宋雨倬；

【导师】 王玉；

【作者基本信息】 兰州大学 ， 营养与食品卫生学， 2013， 硕士

【摘要】 目的分析肺结核患者及肺结核合并糖尿病患者的营养素摄入情况,综合评价肺结核患者及肺结核合并糖尿病患者的膳食质量和膳食结构,为制定营养干预措施提供基础数据及科学依据。了解肺结核合并糖尿病患者的膳食营养摄入状况,为肺结核合并糖尿病患者提供饮食指导。方法随机抽取在甘肃省四个地级市疾病预防控制中心就诊的3350例肺结核患者为调查对象,采用膳食频率法和24小时膳食回顾法进行问卷调查,应用DBI评价肺结核患者的膳食质量。从3350例肺结核患者中共筛查出147例肺结核合并糖尿病患者,另随机抽取147例肺结核患者和健康人群进行面对面膳食营养调查,进行组间比较,分析不同组间的营养素摄入状况。结果一、肺结核患者膳食营养分析1.基本情况：不同性别肺结核患者年龄、BMI、体力活动、文化程度分布有统计学差异(P<0.05)；不同性别肺结核患者地区分布、经济收入之间比较无统计学差异。2.膳食营养分析：与膳食宝塔推荐摄入量相比,肺结核患者以谷薯类为主,蔬菜、水果、鱼虾、奶类每日摄入量明显不足；肺结核患者的24小时膳食调查结果显示,铁摄入量为16.68mg/日,摄入水平超过相应的RNI,其他矿物质、能量物质和维生素普遍摄入不足,其中维生素A、维生素B2、维生素C、钙的摄入量不足RNI的50%。3.运用DBI评价：从正端分(DBI-HBS)、负端分(DBI-LBS)和膳食质量距(DBI-DQD)来看,不同各年龄组、经济收入、文化程度的差异有统计学意义(P<0.05)；谷类食物摄入适宜或达到推荐摄入量的占40.6%,蔬菜和水果摄入充足的占91.47%、74.21%,无严重摄入不足；豆类、奶类、鱼虾类明显摄入不足；应用正端分(DBI-HBS)和负端分(DBI-LBS)的不同分值水平,将膳食分为(A-I)九种模式,其中有37.55%的人膳食模式为A,34.69%的人群是模式B。二、肺结核合并糖尿病患者膳食营养分析1.基本情况：不同性别、年龄、文化程度、体力活动、BMI在健康人群、肺结核组及肺结核合并糖尿病组分布有统计学差异(P<0.05)。2膳食营养分析：肺结核、肺结核合并糖尿病、健康人群组膳食均以谷薯类为主,肺结核合并糖尿病组畜禽肉类及制品每日摄入量低于健康人群组(P<0.05);肺结核合并糖尿病组蔬菜、水果、蛋类、奶类、大豆及其制品每日摄入量低于肺结核组(P<0.01)。肺结核合并糖尿病组蛋类每日摄入量高于健康人群组(P>0.05)；各人群组营养素摄入水平显示,各主要营养素的摄入水平低于全国水平(维生素B1除外)及推荐摄入量(铁除外)。肺结核合并糖尿病组能量、脂肪、维生素B1、维生素C、钾的每日摄入量低于健康人群组(P<0.05)。健康人群、肺结核及肺结核合并糖尿病人群能量来源均以碳水化合物为主,分别占72.29%、76.52%和75.92%。结论肺结核患者矿物质、能量物质和维生素普遍摄入不足,肺结核合并糖尿病患者的膳食种类单一,营养素缺乏等问题仍然存在,营养状况较健康人群和肺结核患者差,建议改善该人群饮食营养状况。更多还原

【Abstract】 Objective To study the dietary and nutrient intake situation of patients with pulmonary tuberculosis and pulmonary tuberculosis associated with diabetes.Comprehensive evaluation of pulmonary tuberculosis and pulmonary tuberculosis in patients with diabetes diet quality and dietary structure, to provide basic data and scientific evidence for nutritional interventions. To understand the status of the tuberculosis patients with diabetes dietary nutrition intake, provide dietary guidance for pulmonary tuberculosis patients with diabetes.Methods randomly in four cities in Gansu province center for disease control and prevention of3350cases of tuberculosis patients as investigation object, and adopts the dietary frequency method and24-hour dietary review method, questionnaire survey, evaluation of pulmonary tuberculosis in patients with DBI dietary quality. From the screening out of a total of3350cases of tuberculosis patients,147cases of pulmonary tuberculosis patients with diabetes, and the other randomly selected147cases of tuberculosis patients and healthy people face to face with dietary nutrition survey, compared between groups, analysis situation between different groups of the intake of nutrients.Results1.Pulmonary tuberculosis patients(1) The basic situation:different gender tuberculosis patients age, BMI, physical activity, cultural level distribution was statistically difference (P<0.05); Different gender TB region distribution, income no statistical difference (P>0.05).(2) Dietary nutritional analysis:compared with the recommended dietary pagoda intake, TB is given priority to with valley potato, vegetables, fruit, fish and shrimp, milk daily intake significantly below; Tuberculosis patients of24hour dietary survey, iron intake of16.68mg/day intake level more than the corresponding RNI, other minerals, insufficient intake of energy substances and vitamins, including vitamin A, vitamin B2, vitamin C, calcium intake of less than50%of RNI.(3) Evaluation:using the DBI from end points (DBI-HBS) of positive and negative end points (DBI-LBS) and spacing (DBI-DQD) diet quality, age, income, educational level among all age groups the difference was statistically significant (P<0.05); Cereal intake is appropriate or achieve accounted for40.6%of the recommended dietary intake, eat plenty of vegetables and fruits was91.47%,74.21%, no serious inadequate intake; Beans, milk, shrimp, obviously inadequate intake; Application is end points (DBI-HBS) and the negative terminal (DBI-LBS) of different scores level, meals can be divided into nine kinds of pattern (A-I), with37.55%of those who diet pattern for A;34.69%of the population is model B, the proportion of the two models.2Pulmonary tuberculosis patients with diabetes(1) The basic situation:different gender, age, culture level, physical activity, BMI in healthy population, distribution of tuberculosis and tuberculosis and diabetes group was statistically difference (P<0.05);(2) Dietary nutritional analysis:tuberculosis, pulmonary tuberculosis, diabetes, healthy people group meals are mainly valley potato, tuberculosis and diabetes group of livestock and poultry meat and products daily intake is lower than the healthy group (P<0.05); Tuberculosis and diabetes group of vegetables, fruits, eggs, milk, soybean and its products daily intake is lower than the tuberculosis group (P<0.01). Tuberculosis and diabetes group eggs daily intake was higher than healthy group (P>0.05); Each group of nutrients intake levels, according to the main nutrients intake levels below the national level (except vitamin Bl) and recommended intake (except iron). Tuberculosis and diabetes group energy, fat, vitamin Bl, vitamin C, potassium daily intake is lower than the healthy group (P<0.05), the daily intake significantly lower than the healthy group (P<0.01); Healthy people with diabetes, pulmonary tuberculosis and tuberculosis energy source are mainly carbohydrates, accounted for72.29%,76.52%and72.29%respectively.Conclusions The intake of minerals, energy and vitamin in tuberculosis patient was universal insufficient. The dietary quality can be used to evaluate quickly. The problem that dietary of a single kind, nutrient deficiency and so on is still exist in pulmonary tuberculosis patient with diabetes, whose health condition is worse than healthy people and TB patient group. So it is suggested to improve the nutritional status of this population.更多还原