缺血性脑卒中史对老年射血分数减低的心力衰竭患者住院期间体适能的影响  

Effect of IS history on hospital fitness in elderly patients with HFrEF

作　　者：康云鹏[1] 郭雯[1] 李江[1] 陈立颖[1] 刘文娴[1] Kang Yunpeng;Guo Wen;Li Jiang;Chen Liying;Liu Wenxian(Cardiac Intensive Care Medical Center,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院心内重症医学中心,100029

出　　处：《中华老年心脑血管病杂志》2023年第2期139-142,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：北京市属医院科研培育计划项目(PX2018026)。

摘　　要：目的 通过简易躯体能力评估法对伴有缺血性脑卒中(IS)病史的老年射血分数减低的心力衰竭(HFrEF)患者住院期间体适能进行评价。方法 连续纳入2019年1月至2021年12月在首都医科大学附属北京安贞医院心内重症医学中心收治的老年HFrEF患者228例,根据既往是否存在IS分为合并IS史组76例和未合并IS史组152例,分析2组基线资料和住院期间体适能状况;本研究体适能较差患者185例和体适能良好患者43例;采用二元logistic回归分析。结果 合并IS史组年龄明显高于未合并IS史组[(71.92±6.99)岁vs(68.94±6.37)岁,P=0.002];合并IS史组握力[(21.59±4.87)kg vs(23.33±4.68)kg,P=0.011],椅子站立测试评分[(2.14±0.91)分vs(2.40±0.82)分,P=0.032],简易机体功能评估总分明显低于未合并IS史组[(7.58±2.02)分vs(8.10±1.68)分,P=0.041];与体适能良好患者比较,体适能较差患者年龄及IS史比例更高,握力及LVEF更低(P<0.05,P<0.01)。二元logistic回归分析显示,年龄和IS史是影响老年HFrEF患者住院期间体适能的危险因素(P<0.05)。结论 IS史是导致老年HFrEF患者住院期间体适能下降的独立危险因素。Objective To evaluate the physical fitness of elderly patients with HFrEF and history of IS during hospitalization by SPPB.Methods A total of 228 consecutive elderly HFrEF patients admitted to our hospital from January 2019 to December 2021 were enrolled in this study.According to having a history of IS or not, they were divided into 76 patients with history of IS and 152 without(control).The baseline data and physical fitness status during hospitalization were recorded.Based on the level of physical fitness, they were also assigned into physical fitness(n=43) and unfitness groups(n=185).Binary logistic regression model was used to analyze the main influencing factors of in-hospital physical fitness decline between the 2 groups.Results The HFrEF patients with history of IS were significantly older(71.92±6.99 years vs 68.94±6.37 years, P=0.002),and had reduced grip strength(21.59±4.87 kg vs 23.33±4.68 kg, P=0.011),and lower score of chair standing test(2.14±0.91 vs 2.40±0.82,P=0.032) and total score of SPPB(7.58±2.02 vs 8.10±1.68,P=0.041) than the control group.Older age, larger proportion of history of IS,and lower grip strength and LVEF were observed in the physical unfitness group than the fitness group(P<0.05,P<0.01).Binary logistic regression analysis indicated that age and history of IS were risk factors for physical fitness decline in elderly HFrEF patients during hospitalization(P<0.05).Conclusion The history of IS is an independent risk factor for decline of physical fitness in elderly HFrEF patients during hospitalization.

关 键 词：卒中 每搏输出量 心力衰竭 年龄因素 住院病人 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R541.6[医药卫生—临床医学]