老年慢性心力衰竭患者不同心功能分级的躯体功能与合并症比较  

A comparative study of physical function and comorbidity burden of elderly patients with chronic heart failure at different stages

作　　者：邱孝丰 冀红美[1] 胡竞 QIU Xiaofeng;JI Hongmei;HU Jing(Northern Medical Branch of PLA General Hospital,Beijing 100094,China;Cardiovascular Department,2nd Cen‐ter of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院京北医疗区,北京100094 [2]解放军总医院第二医学中心心血管内科,北京100853

出　　处：《转化医学杂志》2021年第6期392-395,共4页Translational Medicine Journal

摘　　要：目的对老年慢性心力衰竭(chronic heart failure,CHF)患者的躯体功能及合并疾病进行评估,比较不同心功能分级的患者躯体功能及合并疾病的差异。方法调查2019年1月1日-2020年12月31日在某三甲医院老年心内科住院的CHF患者,根据纽约心脏病协会的心功能分级(NYHA)将患者心功能分为Ⅱ级、Ⅲ级、Ⅳ级,采用巴氏指数(Barthel index,BI)和改良老年疾病累计评分表(modified cumulative illness rating scale-geriatric,MCIRS-G)分别评估患者躯体功能和合并疾病情况,比较不同心功能分级患者的躯体功能及合并疾病的差异,并对各特征相关性进行分析。结果共纳入134例CHF患者,年龄(87.01±8.99)岁。NYHAⅣ级患者的合并疾病累计评分最高(P<0.05)、BI得分最低(P<0.01),老年CHF患者年龄及BMI越大,NT-proBNP越高,合并疾病越多,躯体功能越差。结论老年CHF患者的NYHA分期与其躯体功能及合并疾病严重程度有关,NYHA分期可以作为老年CHF患者躯体功能评估的参考工具,用于对老年CHF患者进行风险分层并进行有针对性干预,以延缓躯体功能下降及日常生活能力的降低。Objective To assess the physical function and comorbidity burden of elderly patients with chronic heart failure(CHF) and compare the difference between each stage. Methods Patients with CHF hospitalized in the cardiovascular department of our hospital from January 1, 2019 to December 31, 2020 were reviewed. The Barthel index and modified cumulative illness rating scale-geriatric(MCIRS-G) were used to evaluate the patients’ physical function and the comorbidity burden in order to compare the difference of NYHA stage and analyze the correlation of different characteristics. Results A total of 134 elderly patients were recruited in the study with age of(87.01±8.99)years.The MCIRS-G score of patient in NYHA Ⅳ stage was significantly higher than that of other stages(P<0.05), the BI score of patient in NYHA Ⅳ stage was significantly lower than that of other stages(P<0.01). The combined diseases was the main influencing factor of physical function in elderly patients with CHF(P<0.01). Conclusion NYHA staging of elderly CHF patients is related to their physical function and the severity of associated diseases. So it can be used as a risk assessment tool for the physical function, which can be used for risk stratification and targeted intervention in elderly CHF patients.

关 键 词：老年人 慢性心力衰竭 心功能分级 躯体功能 合并疾病 

分 类 号：R541.6[医药卫生—心血管疾病]