卒中后老年住院患者吞咽困难、口腔健康负担与粪便检测到的口腔相关菌群：一项横断面研究
Dysphagia, Oral Health Burden, and Stool-Detected Oral-Associated Taxa in Older Inpatients After Stroke: A Cross-Sectional Study.
文献信息
| PMID | 42854972 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yoshihiro Yoshimura |
| 作者单位 | Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-machi, Kikuchi-gun, Kumamoto 869-1106, Japan. Electronic address: hanley.belfus@gmail.com. |
| 期刊 | Clinical nutrition ESPEN |
| SCI 分区 | Q2 |
| IF | 3.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景与目的： 吞咽和经口进食受限以及口腔健康状况不佳可能伴随卒中后粪便微生物谱的改变。我们研究了它们与老年住院患者粪便检测到的口腔相关菌群谱之间的关联。
方法： 这项基于注册的横断面分析纳入了156名年龄≥65岁的住院患者。使用食物摄入水平量表（FILS）和修订版口腔评估指南（ROAG）评估吞咽/经口进食状态和口腔健康。结局是一项研究定义的、标准化的六属粪便检测口腔相关菌群评分。线性回归使用HC3稳健标准误和临床协变量。FILS < 7是主要暴露；连续FILS和ROAG是次要暴露。额外的敏感性分析涉及评分构建、有序FILS、营养暴露、缺失值和模型诊断。
结果： 参与者的平均年龄为78.4岁；55.8%为男性，25人（16.0%）的FILS < 7。在分别调整的模型中，FILS < 7时评分较低（β -0.99；95% CI -1.34至-0.63），FILS每增加1分评分较高（β 0.15；95% CI 0.10-0.20），ROAG每增加1个标准差评分较低（β -0.32；95% CI -0.45至-0.18；所有p < 0.001）。在联合模型中，ROAG的关联减弱（β -0.13；95% CI -0.30至0.03；p = 0.111），而FILS仍保持关联。主要关联在能量/蛋白质调整和诊断检查后仍然存在。
结论： 在分别调整的模型中，较差的吞咽/经口进食状态和更大的口腔健康负担均与较低的粪便检测口腔相关菌群谱相关。这些探索性发现并未确立独立的口腔健康效应、口腔来源、因果关系或临床实用性。
英文摘要
BACKGROUND & AIMS: Swallowing and oral intake limitations and poor oral health may accompany altered stool microbial profiles after stroke. We examined their associations with a stool-detected oral-associated taxa profile in older inpatients.
METHODS: This registry-based cross-sectional analysis included 156 inpatients aged ≥65 years. Swallowing/oral intake status and oral health were assessed using the Food Intake Level Scale (FILS) and Revised Oral Assessment Guide (ROAG). The outcome was a study-defined, standardized six-genera stool-detected oral-associated taxa score. Linear regression used HC3 robust standard errors and clinical covariates. FILS < 7 was the primary exposure; continuous FILS and ROAG were secondary exposures. Additional sensitivity analyses addressed score construction, ordinal FILS, nutritional exposure, missingness, and model diagnostics.
RESULTS: Participants had a mean age of 78.4 years; 55.8% were men, and 25 (16.0%) had FILS < 7. In separately adjusted models, the score was lower with FILS < 7 (β -0.99; 95% CI -1.34 to -0.63), higher per FILS point (β 0.15; 95% CI 0.10-0.20), and lower with each 1-SD increase in ROAG (β -0.32; 95% CI -0.45 to -0.18; all p < 0.001). In the joint model, ROAG was attenuated (β -0.13; 95% CI -0.30 to 0.03; p = 0.111), whereas FILS remained associated. The primary association persisted after energy/protein adjustment and diagnostic checks.
CONCLUSIONS: Poorer swallowing/oral intake status and greater oral health burden were each associated with a lower stool-detected oral-associated taxa profile in separately adjusted models. The exploratory findings do not establish independent oral-health effects, oral origin, causality, or clinical utility.