老年营养风险指数对高龄心力衰竭患者预后的价值  

Predictive value of geriatric nutritional risk index in elderly patients with heart failure

作　　者：李黎[1] 王旭[2] 陈君[1] LI Li;WANG Xu;CHEN Jun(Department of cardiovasculor medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of medicial records,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院心血管内科,郑州450052 [2]郑州大学第一附属医院病案科,郑州450052

出　　处：《医药论坛杂志》2023年第7期1-5,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190098)。

摘　　要：目的 探究营养状况对高龄心力衰竭患者长期预后的影响。方法 选取2017年11月至2018年11月郑州大学第一附属医院收治的参加心力衰竭患者结局注册研究的≥80岁心衰患者1 221例,计算老年营养风险指数(geriatric nutritional risk index,GNRI)并分组:无营养不良风险组(GNRI≥98,384例),营养不良低风险组(92≤GNRI<98,353例)和营养不良中/重度风险组(GNRI<92,484例)。主要研究终点为全因死亡,次要研究终点为心血管死亡。结果 患者平均年龄85岁,68.55%(837例)的患者存在不同程度的营养不良。Kaplan-Meier生存分析显示,中/重度营养不良患者全因死亡及心血管死亡均高于其他两组(P<0.0001)。多因素Cox回归分析提示,与无营养不良的患者相比,中/重度营养不良患者全因死亡及心血管死亡风险均显著增加(HR 1.660,95%CI 1.159~2.377,P=0.006;HR 1.627,95%CI 1.160~2.283,P=0.005)。结论 营养不良在老年心力衰竭患者中常见,中重度营养不良是老年心力衰竭患者死亡的独立危险因素。Objective To explore the influence of nutritional status on long-term prognosis of elderly patients with heart failure.Methods A total of 1221 heart failure patients ≥80 years old who participated in The Heart Failure Registry of Patient Outcomes(HERO) study from November 2017 to November 2018 in The First Affiliated Hospital of Zhengzhou University were enrolled.Based on the geriatric nutritional risk index(GNRI),Patients were divided into three groups:no malnutrition group(GNRI≥98,n=384),low risk of malnutrition group(92≤GNRI<98,n=353),and moderate/severe risk of malnutrition group(GNRI<92,n=484).The primary outcome was all-cause mortality,and the secondary outcome was cardiovascular mortality.Results The mean age was 85 years old and 837 patients(68.55%) were with malnutrition.Kaplan-Meier curve indicated that all-cause mortality and cardiovascular mortality were significantly(P<0.0001) higher in patients with moderate/severe risk of malnutrition group than the other two groups.Multivariate Cox regression analysis indicated that patients with moderate/severe risk of malnutrition had a significantly increased risk of all-cause and cardiovascular death compared with patients without malnutrition(HR 1.660,95%CI 1.159~2.377,P=0.006;HR 1.627,95%CI 1.160~2.283,P=0.005).Conclusion Malnutrition is common in elderly patients with heart failure,and moderate to severe malnutrition is an independent risk factor for death.

关 键 词：心力衰竭 老年营养风险指数 高龄 预后 

分 类 号：R541.6[医药卫生—心血管疾病]