摘要
目的:通过对老年慢性心力衰竭(chronic heart failure, CHF)患者的衰弱指数、血清中白蛋白、前白蛋白和转铁蛋白水平进行统计分析,评估其在老年CHF患者治疗中的临床意义。方法:选取2018年1月—2020年1月在安徽医科大学附属安庆医院住院治疗的老年CHF患者194例作为研究对象,选取同期53例心功能正常老年人作为对照组,检测两组研究对象的血清白蛋白、前白蛋白和转铁蛋白水平,同时依据老年人综合评估(comprehensive geriatric assessment, CGA)的衰弱指数(frailty index, FI)模型(FI-CGA)计算出所有研究对象的衰弱指数,并进行衰弱程度分级;对比两组研究对象衰弱程度分布情况以及血清中白蛋白、前白蛋白和转铁蛋白水平,并分析其与CHF的关系。按照美国纽约心脏协会(New York Heart Association, NYHA)心功能分级将CHF组分为Ⅱ级组81例、Ⅲ级组68例、Ⅳ级组45例3组,对比3个亚组之间衰弱程度分布情况以及血清中白蛋白、前白蛋白和转铁蛋白的差异。结果:老年CHF组患者伴有衰弱、衰弱前期的比例明显高于对照组的,且血清白蛋白、前白蛋白和转铁蛋白水平均低于对照组的,差异有统计学意义(χ^(2)=42.292;t=-7.058、-9.634、-5.318,P<0.05),并随着心功能分级等级增高其衰弱程度增强,而血清白蛋白、前白蛋白和转铁蛋白水平明显下降,差异有统计学意义(χ^(2)=31.638;t=19.410、17.720、40.183,P<0.05)。经相关性分析,心功能分级与血清白蛋白、前白蛋白、转铁蛋白水平呈负相关,差异有统计学意义(r=-0.385、-0.399、-0.548,P<0.05);心功能分级与衰弱指数呈正相关,差异有统计学意义(r=0.574,P<0.05)。结论:老年CHF程度与衰弱指数、血清白蛋白、前白蛋白及转铁蛋白水平存在紧密的联系,CHF患者患有衰弱及血清中低蛋白的风险较高,且衰弱指数与心功能分级呈正相关,血清中蛋白水平与心功能分级呈负相关。在临床上对
Objective:The clinical significance in the treatment of elderly patients with chronic heart failure(CHF) was evaluated by statistically analyzing the debilitation index, serum levels of albumin, prealbumin and transferrin in elderly patients with CHF.Methods:194 elderly patients with CHF hospitalized from January 2018 to January 2020 were selected as study subjects, and 53 elderly patients with normal cardiac function during the same period were selected as control group. Serum albumin, prealbumin and transferrin levels were measured in the two study groups. The frailty index(FI) of the Comprehensive Geriatric Assessment(CGA) model(FI-CGA) was also calculated and the frailty index of all study subjects was graded according to the frailty index of the CGA. The distribution of the degree of debilitation and the serum levels of albumin, prealbumin and transferrin were compared between the two study groups, and their relationship with CHF was analyzed. The CHF group was divided into three groups 81 cases in class Ⅱ, 68 cases in class Ⅲ, and 45 cases in class Ⅳ according to the New York Heart Association(NYHA) cardiac function classification. The distribution of the degree of debilitation and the differences in serum albumin, prealbumin, and transferrin were compared among the three subgroups.Results:The proportion of patients with debilitation and pre-debilitation in the elderly CHF group was significantly higher than that in the control group, and the serum albumin, prealbumin and transferrin levels were lower than those in the control group, with statistically significant differences(P<0.05). As the graded grade of cardiac function increased its degree of debilitation, serum albumin, prealbumin and transferrin levels decreased significantly, with statistically significant differences(P<0.05). Correlation analysis revealed that cardiac function classification was negatively correlated with serum albumin, prealbumin, and transferrin levels, with statistically significant differences(r=-0.385、-0.399、-0.548,
作者
冯小利
陈力量
FENG Xiao-li;CHEN Li-liang(Department of Geriatrics,Anqing Hospital Affiliated of Anhui Medical University,Anqing Anhui,246000,China)
出处
《黑龙江医学》
2023年第3期269-272,共4页
Heilongjiang Medical Journal
关键词
慢性心力衰竭
衰弱指数
血清蛋白
心功能分级
Chronic heart failure
Frailty index
Serum albumin
Grade of cardiac function
