心力衰竭患者营养状态与全因死亡的分析  

Correlation between Nutritional Status and Mortality in Patients with Heart Failure

作　　者：巩昕 朱琛颖[1] 于萍[1] 奚晓玲[1] 胡昊[1] 曹建红[1] 范慧敏[1] Gong Xin, Zhu Chenying, Yu Ping, Xi Xiaoling, Hu Hao, Cao Jianhong, Fan Huimin.(Heart Failure Departement, The East Hospital of Shanghai, Shanghai 200120, Chin)

机构地区：[1]同济大学附属上海市东方医院心力衰竭专科,200120

出　　处：《中华临床营养杂志》2018年第1期34-39,共6页Chinese Journal of Clinical Nutrition

摘　　要：目的探讨心力衰竭患者的营养状态及其对全因死亡的影响。方法选取2013年3月至2015年11月因慢性心力衰竭急性失代偿于上海市东方医院心力衰竭专科住院的患者351例（HFrEF组）。分析其与对照组营养状态的差异。中位随访时间606d后，共108例患者全因死亡。用多因素Logistic回归分析HFrEF组患者体质量指数（BMI）、血清白蛋白等营养指标与全因死亡的关系。结果与对照组相比，HFrEF组患者的BMI[（22．71±3．95）kg／m2比（24．23±3．66）kg／m2，t=4．331，P=0．000]、总胆固醇[（3．81±0．99）mmol／L比（4．03±0．96）mmol／L，t=2．638，P=0．009]、白蛋白[（38．18±5．03）g／L比（40．18±6．12）g/L，t=3．874，P=0．000]、前白蛋白[（187．67±61．83）mg／L比（211．94±65．44）mg／L，t=3．937，P=0．000]均较低。低BMI组死亡49例，高BMI组死亡36例，低BMI组死亡率（36．0％）明显高于高BMI组（22．4％）（P=0．008）。Logistic回归分析显示BMI、年龄为全因死亡的危险因素。结论心力衰竭患者营养不良发生率较高。BMI〈22ks／m2的心力衰竭患者死亡率较高。心力衰竭患者的血清白蛋白及干体质量时的BMI可反映患者的营养状态并对预后有显著影响。Objective To investigate the nutritional status of patients with heart failure and its effect on all-cause mortality. Methods A total of 351 patients with chronic heart failure, who were consecutively admit- ted to the East Hospital of Shanghai from March 2013 to November 2015, were put into the heart failure with re- duced left ventricular ejection fraction （HFrEF） group. They were compared to 222 controls who were admitted during the same period for preclinical heart failure. After a median follow-up time of 606 days, 108 patients of the HFrEF group died, compared to 11 of the controls. Logistic regression was used to analyze correlations of all-cause mortality with the patients＇ body mass index （BMI） , serum albumin and other factors. Results Com- pared to the controls, patients with chronic heart failure had lower BMI [ （22. 71±3.95） kg/m2 vs. （24. 23± 3.66） kg/m2, t=4.331, P=0.000], total cholesterol [ （3.81±0.99） mmol/L vs. （4.03±0.96） mmol/L, t=2.638, P=0. 009], albumin [ （38.18±5.03） g/Lvs. （40. 18±6. 12） g/L, t=3.874, P=0. 000] and prealbumin [ （187.67±61.83） mg/Lvs. （211.94±65.44） mg/L, t=3.937, P=0. 000]. Within the HFrEF group, patients with lower BMI had higher mortality （ 36. 0% vs. 22.4%, P = 0. 008 ）. Logistic regres- sion suggested BMI, age were independent predictors of all-cause death. Conclusions Patients with chronic heart failure had high incidence of malnutrition, and those with BMI〈22 kg,/m2 had higher risk of mortality. Se- rum albumin and BMI not only reflected nutritional status of the patients but had significant implications on prognosis

关 键 词：左心室射血分数降低的心力衰竭 营养状态 全因死亡 

分 类 号：R541.6[医药卫生—心血管疾病]