控制营养状态评分与老年慢性心衰急性发作患者死亡预后的相关性研究  

Study on the correlation between controlling nutritional status score and death prognosis in elderly patients with acute episode of chronic heart failure

作　　者：庄宸麟 余惠珍[2] 陈毓岱 孙嘉峰[4] 余鹏[2] 陈清 朱鹏立[5] ZHUANG Chenlin;YU Huizhen;CHEN Yudai;SUN Jiafeng;YU Peng;CHEN Qing;ZHU Pengli(Department of Internal Medicine,Fujian Provincial Hospital South Branch,Department of Geriatric Medicine,Provincial Climical Medical College of Fujian Medical University,Fuzhou,Fujian 350007,China)

机构地区：[1]福建医科大学省立临床医学院老年医学研究室,福建省立医院南院内科,福州350001 [2]福建省立医院南院内科 [3]福建省立医院南院消化内镜中心 [4]福建省立医院南院检验科 [5]福建医科大学省立临床医学院老年医学研究室

出　　处：《福建医药杂志》2023年第2期16-19,共4页Fujian Medical Journal

摘　　要：目的探究控制营养状态(CONUT)评分与老年慢性心衰(CHF)急性发作患者死亡预后的相关性.方法连续性纳入年龄≥60岁,因CHF急性发作在我院住院患者共224例.以全因死亡为终点事件,将随访期间发生死亡的患者归为死亡组(n=36),余下患者归为对照组(n=176).对每位患者入院时进行CONUT评分.采用SPSS23.0软件进行统计分析.结果死亡组与对照组相比,体质量指数、心率、淋巴细胞、血红蛋白、总蛋白、清蛋白、总胆固醇、估测的肾小球滤过率降低,CONUT评分、LogNT-proBNP升高,差异有统计学意义(P<0.05).多因素Cox回归分析显示,CONUT评估的营养不良严重程度与死亡事件相关(P<0.05).Kaplan-Meier生存曲线显示,老年CHF急性发作伴营养不良患者的死亡率高于营养正常状态患者,两者之间差异有统计学意义.结论营养不良状态是老年CHF急性发作患者远期死亡预后不良的独立危险因素.采用CONUT评分进行营养评估可较准确地评估营养状况.Objective To explore the death prognostic value of controlling nutritional status(CONUT)score in elderly patients with acute episode of chronic heart failure were enrolled.Methods A total of 224 elderly patients(age≥60 years)hos-pitalized for acute episode of chronic heart failure.The primary outcome during followup was all cause mortality.Patients were divided into two groups:death group(n=36)and control group(n=176).The nutrition stages of patients were evaluated with CONUT.We used software SPSS 23.0 to analyze the basic data.Results The death group had lower body mass index,heart rate,diastolic pressure,lymphocyte,hemoglobin,total protein,albumin,total cholesterol,estimated glomerular filtration rate,compared with control group.However,they had higher CONUT score and LogNT proBNP(P<0.05).Multivariate Cox regression analysis showed that malnutrition assessed by CONUT score was an independent risk factor for mortalify in eld-erly patients with acute episode of chronic heart failure(P<0.05).The Kaplan-Meier survival curve showed that the hortality of malnourished patients was significantly higher than that of non malnourished patients.Conclusion Malnutrition is independ-ently associated with long term survival in elderly patients hospitalised with acute episode of chronic heart failure.CONUT can be effective to evaluate the nutritional status.

关 键 词：心力衰竭 老年 营养状况 预后 控制营养状态评分 

分 类 号：R541.6[医药卫生—心血管疾病]