摘要
目的评估老年心力衰竭(心衰)住院患者的营养状态并分析其危险因素。方法纳入2018年1月至2019年3月本院收治的221例老年心衰患者,收集一般资料及病情资料,行NRS-2002营养筛查及心衰相关问卷调查。采用Mann-Whitney U检验或χ2检验比较各因素对检出率的影响,多因素Logistic回归分析其独立危险因素。结果221例患者中营养不良风险检出率为45.2%,文化程度越低、心功能越差,检出率越高(P<0.05);心衰合并周围血管病、骨质疏松检出率高于未合并者(P<0.05),且随并发症、服药数量增多而增加(P<0.05)。营养不良风险组衰弱程度更高、生活质量更差(P<0.05)。多因素Logistic回归分析发现年龄、射血分数、血脑利钠肽、美国纽约心脏病子会分级、药物及疾病数量、衰弱、生活质量下降为其独立危险因素(P<0.05),地高辛为其独立保护因素(P<0.05)。结论高龄、心衰程度、疾病和服药数量、衰弱及生活质量下降可能为老年心衰患者营养不良风险的独立危险因素;口服地高辛可能为其独立保护因素。
Objective To evaluate the nutritional status of elderly inpatients with heart failure,and to analyze risk factors for malnutrition.Methods A total of 221 patients with heart failure in our hospital from January 2018 to March 2019 were enrolled in the study.The demographic characteristics and medical record data were collected.All patients received Nutritional Risk Screening 2002(NRS-2002)and a questionnaire survey relating to heart failure.We investigated the effects of risk factors on the detection rate of malnutrition by using Mann-Whitney U test or Chi-square test,and the independent risk factors for malnutrition were analyzed by multivariate Logistic regression analysis.Results The detection rate of nutritional risk was 45.2%in 221 patients.The detection rate of nutritional risk increased along with lower degree of education and worse cardiac function(P<0.05).The detection rate of nutritional risk was higher in patients with peripheral vascular disease and osteoporosis than in patients without them(P<0.05),and in patients with the increased numbers of complication and drugs(P<0.05).Patients with nutritional risk had a higher degree of frailty and a worse quality of activities of daily living(P<0.05).Multivariate Logistic regression analysis indicated that great age,ejection fraction,B-type natriuretic peptide(BNP),NYHA classification,numbers of drugs and diseases,frailty,low quality of life were independent risk factors for nutritional risk,and Digoxin was the independent protective factor for nutritional risk(P<0.05).Conclusions The great age,severity of heart failure,numbers of drugs and diseases,frailty,low quality of daily life may be the independent risk factors for nutritional risk in elderly patients with heart failure,and oral Digoxin may be the independent protective factor for nutritional risk.
作者
李雯曦
刘国顺
彭程
楼慧玲
Li Wenxi;Liu Guoshun;Peng Cheng;Lou Huiling(Department of Geriatrics,Guangzhou First People's Hospital,Guangzhou 510180,China;Department of Radiology,Guangzhou First People's Hospital,Guangzhou 510180,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2020年第2期137-142,共6页
Chinese Journal of Geriatrics
基金
广东省医学科学技术研究基金(A2019005)
广州市科技计划(201903010091)。
