入院营养状态对超高龄高血压患者近期非致死性心血管事件发生率的影响

Impact of nutrition status on admission on the incidence of non-fetal cardiovascular events in super-elderly hypertensive patients

目的探讨超高龄高血压患者入院时营养状态与近期(90 d)非致死性心血管事件(non-fetal cardiovascular events,NFCE)发生的关系。方法采用队列研究法,入选本院高龄老年心血管疾病数据库中2011年1月-2013年12月住院的80岁以上高血压患者,根据入院时控制营养指数(controlling nutritional status,CONUT)积分进行分组,观察入院后7 d、14 d、30 d、90 d时心血管事件发生情况并进行分析。结果 90 d随访结果显示,入院正常营养状态、轻度营养异常、中度营养异常及重度营养异常组患者非致死性心血管事件的发生率分别是4%、10.90%、20.78%及36.54%,CONUT积分增高,NFCE发生率明显增高(χ~2=97.448,P=0.000)。Logistic回归分析显示,CONUT指数是90 d非致死性心血管事件的独立危险因子(OR=1.188,95%CI:1.042~1.354,P=0.01)。结论超高龄高血压患者入院时营养状况与其预后密切相关,CONUT指数升高,预示着不良事件发生率的增加。

Objective To discuss the effect of nutritional status on admission on incidence of non fatal cardiovascular events within 90 d in super elderly patients with hypertension in hospital. Methods This is a cohort study. The patients aged over 80 with hypertension hospitalized in Chinese PLA General Hospital from Jan 2011 to Dec 2013 were chosen. According to the nutritional status on admission,patients were divided into four groups and the incidences of non-fatal cardiovascular events at 7 d（D7）,14 d（D14）,30 d（D30） and 90 d（D90） were recorded. Results Those patients scored high for controlling nutritional status（CONUT） which means worse nutritional status showed higher incidence of non-fetal cardionvascular events（χ^2=97.448,P=0.0000）. Logistic regression analysis showed that CONUT was independent risk factor of non-fatal cardiovascular events（OR=1.188,95% CI：1.042-1.354,P=0.01）. Conclusion In super elderly patients with hypertension,the nutritional status on admission is independent risk factor of non fatal cardiovascular events. Increased CONUT means worse nutritional status,which links to poor prognosis. The effective treatment of mulnutrition may reduce the unfavorable prognosis in the super-elderly hypertensive patients.