骨骼肌质量与内脏脂肪面积比值对老年射血分数保留心力衰竭病人预后的影响  

Effect of skeletal muscle mass to visceral fat area ratio on the prognosis in elderly patients with heart failure with preserved ejection fraction

作　　者：汉军成 范晓涌 余静[1] HAN Juncheng;FAN Xiaoyong;YU Jing(Department of Cardiology,Lanzhou University Second College of Clinical Medicine,Lanzhou,Gansu 730030,China;Department of Cardiology,Lanzhou First People´s Hospital,Lanzhou,Gansu 730050,China)

机构地区：[1]兰州大学第二医院心血管内科,甘肃兰州730030 [2]兰州市第一人民医院心血管内科,甘肃兰州730050

出　　处：《安徽医药》2023年第4期693-698,共6页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金面上项目(81670385)。

摘　　要：目的研究骨骼肌质量与内脏脂肪面积比值(skeletal muscle massto visceral fat area ratio,SVR)对老年射血分数保留心力衰竭(heart failure with preserved ejection fraction,HFpEF)病人预后的影响。方法选取2019年1—9月在兰州市第一人民医院就诊的老年HFpEF病人94例,出院前收集临床资料,测定病人的SVR水平,将SVR按三分位数分成T1-T3组,进行为期2年随访,终点事件为心力衰竭相关事件(heart failure-related events,HFRE),比较不同组HFpEF病人的预后差异及其影响因素。结果三组病人临床资料分析:年龄、体质量指数、腰围、收缩压、NT-proBNP、三酰甘油、左心房容积指数、左室射血分数、白细胞介素-6、附肢骨骼肌质量[T1(13.4±2.1)kg、T2(15.6±2.3)kg、T3(18.7±2.5)kg]、内脏脂肪面积[T1(152.7±28.7)cm^(2)、T2(143.2±26.1)cm^(2)、T3(131.5±24.3)cm^(2)]均差异有统计学意义(P<0.05),对上述变量行多因素Cox回归分析表明SVR、年龄、左心房容积指数、体质量指数是HFRE的独立危险因素(P<0.05)。结论老年HFpEF病人身体成分的改变与HFRE存在联系。Objective To investigate the effect of skeletal muscle mass to visceral fat area ratio(SVR)on the prognosis of elderly patients with heart failure with preserved ejection fraction(HFpEF).Methods A total of 94 HFpEF patients aged 60 and over who were treated in the Lanzhou First People's Hospital from January to September 2019 were selected.The SVR level of the patients was measured before discharge.All patients were divided into three groups according to the SVR tertiles(T1-T3).The clinical data of the patients were collected and followed up for 2 years.The end event was heart failure related events(HFRE).The differences of HFpEF patients in different groups were compared.Results Clinical data analysis of three groups of patients:age,body mass index,waist circumference,systolic blood pressure,NT-proBNP,triglyceride,left atrial volume index,left ventricular ejection fraction,interleukin-6,appendage skeletal muscle mass[T1(13.4±2.1)kg,T2(15.6±2.3)kg,T3(18.7±2.5)kg],visceral fat area[T1(152.7±28.7)cm^(2),T2(143.2±26.1)cm^(2),T3(131.5±24.3)cm^(2)]were statistically different(P<0.05).Multivariate Cox proportional risk regression model for these variables showed that SVR,age,left atrial volume index and body mass index were independent risk factors for HFRE(P<0.05).Conclusion Changes in body composition are associated with HFRE in elderly patients with HFpEF.

关 键 词：心力衰竭 舒张性 每搏输出量 老年人 射血分数保留心力衰竭 骨骼肌质量与内脏脂肪面积比值 心力衰竭相关事件 

分 类 号：R541.6[医药卫生—心血管疾病]