摘要
目的:探讨老年慢性心力衰竭(CHF)病人营养状态与不良心脏事件发生的关系。方法:选取2019年9月—2022年7月在四川大学华西医院进行治疗的102例老年CHF病人,按照改良微型营养评定(MNA)评分将其分为营养不良组(41例)、营养不良风险组(33例)、营养良好组(28例),比较3组甲状腺激素(TH)指标、心功能指标,记录3组心脏不良事件发生率,并分析心脏不良事件发生率与营养指标的相关性。结果:营养不良组三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3)水平均明显低于营养不良风险组、营养良好组(P<0.05),营养不良风险组T3、FT3水平明显低于营养良好组(P<0.05),但3组甲状腺激素(T4)、游离甲状腺激素(FT4)、促甲状腺激素(TSH)指标比较差异无统计学意义(P>0.05);营养不良组左心室射血分数(LVEF)明显低于营养不良风险组、营养良好组,左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、氨基末端脑钠肽前体(NT-proBNP)高于营养不良风险组、营养良好组(P<0.05)。营养不良风险组LVEF明显低于营养良好组(P<0.05),LVEDD、LVESD、NT-proBNP高于营养良好组(P<0.05)。营养不良组心脏不良事件发生率明显高于营养不良风险组、营养良好组(P<0.05),营养不良风险组心脏不良事件发生率略高于营养良好组,差异无统计学意义(P>0.05)。发生心脏不良事件病人血红蛋白(Hb)、前白蛋白(PAB)、清蛋白(ALB)均明显低于未发生心脏不良事件病人(P<0.05),且相关性分析发现,心脏不良事件与营养指标呈负相关(P<0.05)。结论:老年CHF病人营养状态越差,发生不良心脏事件风险越高,可能与营养不良影响机体T3、FT3及心功能指标有关。
Objective:To explore the relationship between nutritional status and adverse cardiac events in elderly patients with chronic heart failure(CHF).Methods:A total of 102 elderly CHF patients were selected and divided into malnutrition group(41 cases),malnutrition risk group(33 cases),and better nutrition group(28 cases)according to Mini Nutrition Assessment(MNA)score.Thyroid hormone(TH)indexes and cardiac function indexes were compared among the three groups.The incidence of adverse cardiac events in 3 groups were recorded,and the correlation between the incidence of adverse cardiac events and nutritional indexes was analyzed.Results:The levels of triiodothyronine(T3)and free triiodothyronine(FT3)in malnutrition group were significantly lower than those in malnutrition risk group and good nutrition group(P<0.05).The levels of T3 and FT3 in malnutrition risk group were significantly lower than those in good nutrition group(P<0.05).There were no significant difference in thyroid hormone(T4),free thyroid hormone(FT4)and thyroid stimulating hormone(TSH)among the three groups(P>0.05).Left ventricular ejection fraction(LVEF)in malnutrition group was significantly lower than that in malnutrition risk group and better nutrition group,while left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and N-terminal pro brain natriuretic peptide(NT-proBNP)were significantly higher than those in malnutrition risk group and good nutrition group(P<0.05).LVEF in malnutrition risk group was significantly lower than that in good nutrition group,while LVEDD,LVESD and NT-proBNP were higher than those in better nutrition group(P<0.05).The incidence of adverse cardiac events in malnutrition group was significantly higher than that in malnutrition risk group and better nutrition group(P<0.05).The incidence of adverse cardiac events in malnutrition risk group was slightly higher than that in better nutrition group,but there was no significant difference between the two groups(P>0.05).Hemoglobin(Hb),prealbum
作者
柳娜
倪子均
徐英
LIU Na;NI Zijun;XU Ying(West China Hospital,Sichuan University,Chengdu 610213,Sichuan,China)
出处
《中西医结合心脑血管病杂志》
2024年第11期2014-2017,共4页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
关键词
慢性心力衰竭
老年人
营养状态
不良心脏事件
心功能
chronic heart failure
elderly patients
nutritional status
adverse cardiac event
cardiac function
