老年心力衰竭患者营养风险评估的临床意义  

The clinical value of nutritional risk screening in elderly patients with heart failure

作　　者：赵新闻[1] 王梦娟 荣瑗瑗 宋达琳[2] Zhao Xinwen;Wang Mengjuan;Rong Yuanyuan(Department of Emergency,the Affiliated Qingdao Municipal Hospital of Medical College of Qingdao University,Qingdao 266071,China)

机构地区：[1]青岛大学医学院附属青岛市市立医院东院区急诊科,266071 [2]青岛大学医学院附属青岛市市立医院东院区老年内科,266071

出　　处：《中华保健医学杂志》2018年第3期184-187,共4页Chinese Journal of Health Care and Medicine

基　　金：2013中国医师协会探索心血管研究基金(DFCMDA201303)

摘　　要：目的研究住院老年心力衰竭患者的营养风险发生率及其与心功能和再入院的关系,探讨营养风险筛查2002(NRS 2002)评分在临床中的应用价值。方法采用前瞻性研究方法 ,选取2015年6月~2016年6月在市立医院住院的老年心力衰竭患者137例,据NRS 2002评分结果分为NRS≥3分组(n=65例)和NRS<3分组(n=72例),收集两组患者的临床资料并进行随访,其主要事件为心力衰竭再入院。结果老年心力衰竭患者营养风险发生率高达47.45%,且年龄越大发生率越高。NRS≥3分组患者心功能Ⅲ级和Ⅳ级的比例明显升高,且NRS 2002评分越高心功能越差(P<0.05)。二元logistic回归分析发现,NRS 2002评分是老年心力衰竭患者再入院的预测因子,且≥3分组患者再入院时间明显缩短。ROC曲线显示,NRS2002评分对预测老年心力衰竭患者再入院的曲线下面积为0.696(95%CI:0.587~0.805,P<0.001),敏感性和特异性分别为59.4%和76.2%。结论高NRS 2002评分的老年心力衰竭患者再入院发生率高、且再入院间隔明显缩短。NRS 2002评分作为独立预测因子在老年心力衰竭患者综合评估和预后方面有着重要的临床意义。Objective To study the relationship between the incidence of nutritional risk and cardiac function and readmission in elderly patients with heart failure,and to access the clinical value of nutritional risk screening. Methods In this prospective study,137 hospitalized and elderly patients with heart failure between June 2015 and June 2016 were enrolled and divided into two groups based on the score of NRS 2002（NRS ≥ 3 score,n =65;NRS 3 score,n =72）from the Department of Qingdao Municipal Hospital. The clinical characteristics were obtained and compared. The main event was defined as readmission due to heart failure（HF） during follow-up. Results The incidence of nutrition risk in elderly patients was 47.45%,and the rate of nutritional risk in elderly patients was higher（P〈0.05）. HF patients with NRS ≥ 3 were related with worse NYHA function class and the higher scores of NRS 2002,the worse function of heart. The binary logistic regression analysis revealed that NRS 2002 was an independent predictor of readmission in elderly HF patients,and the time of readmission in patients with NRS ≥ 3 was shorter. The area under the ROC curve of NRS 2002 was 0.696（P〈0.01） to predict readmission in elderly HF patients,with a sensitivity of59.4%and a specificity of 76.2%,respectively. Conclusion The rate of readmission in patients with NRS ≥ 3 is higher,and the time is significantly reduced.NRS 2002 is an independent predictor of readmission of elderly patients with HF in hospital and is significantly associated with the readmission and prognosis.

关 键 词：营养风险筛查2002(NRS 2002) 心力衰竭 营养情况 再入院 

分 类 号：R541.6[医药卫生—心血管疾病]