MNA-SF在老年慢性心力衰竭患者营养评估中的应用价值  

Clinical value of MNA-SF in nutritional assessment of elderly patients with chronic heart failure

作　　者：韩莹 刘超 宋岩[1] 胡松[1] 

机构地区：[1]青岛大学附属医院老年医学科,山东青岛266000 [2]山东大学齐鲁医院(青岛)心外科,山东青岛266035

出　　处：《检验医学与临床》2018年第3期327-330,共4页Laboratory Medicine and Clinic

摘　　要：目的研究微型营养评估精法(MNA-SF)在老年慢性心力衰竭(CHF)患者营养评估中的应用价值,以及MNA-SF与心力衰竭严重程度的关系。方法选取2015年10月至2016年10月在青岛大学附属医院老年医学科住院的老年患者164例,依据纽约心脏病协会(NYHA)心功能分级,分为心功能Ⅰ级40例,Ⅱ级40例,Ⅲ级41例,Ⅳ级43例。其中,Ⅰ级设为对照组,Ⅱ~Ⅳ级统称为CHF组。采用MNA-SF评估患者营养状态。测定各组体质量指数(BMI)、清蛋白(ALB)、前清蛋白(PA)、血红蛋白(Hb)及N端前脑钠肽(NT-proBNP)水平,观察各检测指标与MNA-SF的相关性,研究MNA-SF分值与心功能分级的关系。结果 CHF组营养不良发生率明显高于对照组,差异有统计学意义(P<0.05)。MNA-SF≤11分的患者BMI、ALB、PA及Hb水平均低于MNA-SF>11分的患者,差异有统计学意义(P<0.05)。MNA-SF分值与BMI、ALB、PA、Hb水平呈正相关,与NT-proBNP水平呈负相关(P<0.05)。MNA-SF分值、PA水平在Ⅰ~Ⅳ级各组间比较差异均有统计学意义(P<0.05)。ALB水平在Ⅰ~Ⅳ级各组间比较,其中对照组与心功能Ⅱ级组间比较差异无统计学意义(P>0.05),其他各组间比较差异均有统计学意义(P<0.05)。结论老年CHF患者营养不良发生率较高,MNA-SF可作为老年CHF患者营养评估的工具;MNA-SF分值及PA水平可作为评估心力衰竭严重程度的敏感指标。Objective To investigate the value of MNA-SF in nutritional assessment of elderly patients with chronic heart failure and the relationship between MNA-SF and the severity of heart failure.Methods A total of 164 elderly patients who were hospitalzed in the Affiliated Hospital of Qingdao University from October 2015 to October 2016 were selected.According to the New York Heart Association(NYHA)classification of heart function,they were divided into gradeⅠ(40 cases),gradeⅡ(40 cases),gradeⅢ(41 cases),gradeⅣ(43 cases).Among them,Ⅰ grade was set as the control group,Ⅱ-Ⅳ grade collectively referred to as chronic heart failure(CHF)group.Patients were evaluated for nutritional status using MNA-SF.The body mass index(BMI),albumin(ALB),pre-albumin(PA),hemoglobin(Hb)and NT-proBNP in each group were measured.The correlation between each test index and MNA-SF were observed.The relationship between MNA-SF score and cardiac function classification were studied.Results The incidence of malnutrition in CHF group was significantly higher than that in control group,the difference was statistically significant(P<0.05).The patients with MNA-SF≤11 points had lower BMI,ALB,PA and Hb levels than those with MNA-SF> 11 points,the difference was statistically significant(P<0.05).The scores of MNA-SF positively correlated with the levels of BMI,ALB,PA and Hb,but negatively correlated with the level of NT-proBNP(P<0.05).MNASF scores,PA levels in the Ⅰ-Ⅳ level between the groups were statistically significant differences(P<0.05).The levels of ALB were compared between groupsⅠ-Ⅳ,there was no significant difference between the control group and the cardiac function Ⅱ group(P>0.05),the differences among the other groups were statistically significant(P<0.05).Conclusion The incidence of malnutrition in elderly CHF patients is high,and MNA-SF could be used as a tool for nutritional assessment of senile CHF patients.MNA-SF score and PA level could be used as sensitive indicators to evaluate the severity of heart failure.

关 键 词：心力衰竭 微型营养评估精法 营养评估 营养不良 

分 类 号：R541.4[医药卫生—心血管疾病]