心力衰竭患者的营养状况及生理功能指标对预后的影响  

Influence of assessments of nutritional status and physiological function on prognosis in patients with heart failure

作　　者：赵会连[1] 牛津津 张静[2] Zhao Huilian;Niu Jinjin;Zhang Jing(Third Department of Cardiovascular Medicine,First People's Hospital of Pingdingshan City,Pingdingshan 467000,China;不详)

机构地区：[1]平顶山市第一人民医院心血管内三科,平顶山467000 [2]平顶山市第一人民医院全科医学科,平顶山467000

出　　处：《中国循证心血管医学杂志》2022年第12期1500-1502,1506,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的 探讨心力衰竭患者的营养状况及生理功能指标对预后的影响。方法 选择平顶山市第一人民医院于2020年1月至2022年2月就诊的95例心力衰竭(心衰)患者纳入观察组,另选择同期我院健康体检者95例为对照组。比较两组的血红蛋白(Hb)、前白蛋白(PAB)、人血清白蛋白(HSA)、转铁蛋白(TRF)、血浆黏度(PV)、红细胞压积(HCT)、红细胞聚集指数(RBCAI)、血液黏度(BV)、血流量(BFV)、阻力指数(RI)、收缩期速度峰值(PSV)、舒张末期血流速度(EDV)的指标水平情况。观察组患者依照根据心力衰竭的MUSIC危险评分对预后分成预后良好组(60例,MUSIC危险评分0~19分)、预后不良组(35例,MUSIC危险评分20~40分),比较不同预后组上述指标的变化。采用多因素Logistic回归分析Hb、PAB、HAS、TRF、PV、HCT、RBCAI、BV、BFV、RI、PSV、EDV对心衰患者预后的危险因素。结果 观察组血清Hb、PAB、HAS、TRF水平均明显低于对照组(P<0.05);观察组PV、HCT、RBCAI、BV、RI水平明显高于对照组,而PSV、EDV、BFV水平明显低于对照组(P<0.05);预后良好组血清Hb、PAB、HAS、TRF水平均明显高于预后不良组(P<0.05);预后良好组PV、HCT、RBCAI、BV、RI水平均明显低于预后不良组,PSV、EDV、BFV水平均明显高于预后不良组(P<0.05);采用Logistic回归性分析结果显示,Hb、PAB、HAS、TRF、PV、HCT、RBCAI、BV、RI、PSV、EDV、BFV均是影响心衰患者预后的危险因素(P<0.05)。结论 心衰患者的营养状况呈现低表达,生理功能中的血液流变学、血流动力学水平失衡与预后紧密相关,在临床中对营养指标及生理功能指标联合检测,有助于评估患者预后。Objective To discuss the influence of assessments of nutritional status and physiological function on prognosis in patients with heart failure(HF). Methods HF patients were chosen into observation group and healthy controls were chosen into control group(each n=95) from the First People’s Hospital of Pingdingshan City from Jan. 2020to Feb. 2022. The indexes of hemoglobin(Hb), prealbumin(PAB), human serum albumin(HSA), transferrin(TRF), blood viscosity(BV), hematocrit value(HCT), red blood cell aggregation index(RBCAI), blood viscosity(BV), blood flow volume(BFV), resistance index(RI), peak systolic velocity(PSV) and end-diastolic velocity(EDV) were compared between 2groups. The observation group was divided further, according to MUSIC risk scoring of HF, into good prognosis subgroup(n=60, MUSIC from 0 to 19) and poor prognosis subgroup(n=35, MUSIC from 20 to 40), and all above-mentioned indexes were compared between 2 subgroups. The influence of Hb, PAB, HAS, TRF, PV, HCT, RBCAI, BV, BFV, RI, PSV and EDV on prognosis and risk factors were analyzed by using multi-factor Logistic regression analysis. Results The levels of Hb, PAB, HAS and TRF were significantly lower in observation group than those in control group(P<0.05). The levels of PV, HCT, RBCAI, BV and RI were significantly higher, and levels of PSV, EDV and BFV were significantly lower in observation group than those in control group(P<0.05). The levels of Hb, PAB, HAS and TRF were significantly higher in good prognosis subgroup than those in poor prognosis subgroup(P<0.05). The levels of PV, HCT, RBCAI, BV and RI were significantly lower, and levels of PSV, EDV and BFV were significantly higher in good prognosis subgroup than those in poor prognosis subgroup(P<0.05). The results of multi-factor Logistic regression analysis showed that Hb, PAB, HAS,TRF, PV, HCT, RBCAI, BV, RI, PSV, EDV and BFV all were risk factors for poor prognosis in HF patients(P<0.05).Conclusion The nutritional status presents low expression in HF patients, and the imbalance of hemo

关 键 词：心力衰竭 营养状况 生理功能 预后 

分 类 号：R541.61[医药卫生—心血管疾病]