老年慢性心力衰竭患者营养不良与心功能的关系  

Relationship between malnutrition and cardiac function in elderly chronic heart failure patients

作　　者：鲁敏[1] 秦兴雷[1] 孙琳[1] 吴彧[1] 

机构地区：[1]郑州大学人民医院康馨心血管内科,450003

出　　处：《中华老年心脑血管病杂志》2014年第11期1157-1160,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：河南省二〇一一科技发展计划(112102310223)

摘　　要：目的探讨老年慢性心力衰竭(CHF)患者营养不良与心功能的关系。方法选择年龄≥65岁的CHF患者170例作为CHF组,其又按年龄分为<80岁组87例和≥80岁组83例;选择同期非CHF患者81例作为非CHF组,对入组患者的体格检查、超声心动图检查和生化检验进行对比分析。结果与非CHF组比较,CHF组血清白蛋白[(37.24±3.90)g/L vs(32.94±3.35)g/L,P=0.000]、血清前白蛋白[(235.76±50.64)mg/L vs(183.98±71.53)mg/L,P=0.000]均显著降低(P<0.01)。与<80岁组比较,≥80岁组前白蛋白显著降低[(203.34±60.63)mg/L vs(165.70±78.40)mg/L,P=0.001]。血清前白蛋白和血清白蛋白与LVEF呈正相关(r=0.267,r=0.251,P<0.05),而体质量指数与LVEF无相关(P>0.05)。结论营养不良可加重老年CHF患者左心室收缩功能障碍。血清前白蛋白是年龄≥80岁CHF患者预后不良的一个独立危险因素。Objective To study the relationship between malnutrition and cardiac function in elderly chronic heart failure （CHF） patients.Methods One hundred and seventy CHF patients with their age ≥65 years served as a CHF group.The patients were divided into ＜80 years old group （n=87） and ≥80 years old group （n=83）.Eighty-one non-CHF patients served as a non-CHF group.The patients underwent clinical examination,laboratory tests,echocardiography and biochemical tests with the findings compared.Results The BMI and serum albumin and prealbumin level were significantly higher in CHF group than in non-CHF group （P＜0.01）.The serum prealbumin level was significantly higher in ≥ 80 years old group than in ＜ 80 years old group （203.34±60.63 mg/L vs 165.70±18.09 mg/L,P=0.001）.The serum albumin and prealbumin levels were positively related with LVEF （r=0.251,r=0.267,P＜0.05）.However,BMI was not directly related with LVEF（P＞0.05）.Conclusion Malnutrition can exacerbate the left ventricular contraction function,and serum prealbumin level is an independent risk factor for poor outcomes in elderly CHF patients with their age ≥80 years.

关 键 词：心力衰竭 营养不良 血清白蛋白 前白蛋白 预后 

分 类 号：R541.6[医药卫生—心血管疾病]