CHF患者营养风险状况与心功能的相关性

Correlation between nutritional risk status and cardiac function in CHF patients

目的:探讨慢性心力衰竭(CHF)患者营养风险状况与心功能的相关性。方法:根据营养风险筛查2002(NRS2002)评分,于我科住院的231例CHF患者被分为营养风险组(≥3分,134例)和无营养风险组(<3分,97例)。比较两组血清脑钠肽(BNP)、血红蛋白(Hb)水平等指标及随访6个月内病死率、再住院率,并分析血浆BNP水平,NRS2002评分等指标与NYHA心功能分级的相关性。结果:与无营养风险组比较,营养风险组年龄、血清BNP水平、NYHA Ⅲ级、Ⅳ级比例均显著升高,血浆白蛋白(Alb)、前白蛋白(PA)水平、LVEF、人体质量指数(BMI)、NYHA Ⅱ级比例均显著降低(P<0.05或<0.01)。随访期间,营养风险组死亡率(18.66%比8.25%)、再住院率(29.10%比16.49%)均显著高于无营养风险组,P均=0.026。Spearman相关分析显示,心功能分级与血清BNP水平、NRS2002评分呈显著正相关(r=0.802,0.393,P均=0.001),与血浆PA、Hb、Alb水平、BMI、LVEF呈显著负相关(r=-0.822^-0.203,P均<0.01)。结论:营养风险状况对CHF患者心功能有显著影响,且心功能分级与血清BNP水平、NRS2002评分呈显著正相关。

Objective:To explore correlation between nutritional risk status and cardiac function in patients with chronic heart failure(CHF). Methods: According to score of nutritional risk screening 2002(NRS2002), a total of 231 CHF patients from our department were divided into nutritional risk group(≥3 scores, n=134) and no nutritional risk group(<3 scores, n=97).Serum levels of brain natriuretic peptide(BNP) and hemoglobin(Hb) etc. and incidence rates of mortality and rehospitalization during six-month follow-up were compared between two groups. Correlation between serum BNP level,scores of NRS2002 etc. and NYHA cardiac function class were analyzed. Results:Compared with no nutritional risk group, there were significant rise in age,serum BNP level and percentages of NYHA class Ⅲ and Ⅳ, and significant reductions in plasma levels of albumin(Alb) and prealbumin(PA), left ventricular ejection fraction(LVEF), body mass index(BMI) and percentage of NYHA class Ⅱ in nutritional risk group(P<0.05 or<0.01). During follow-up, mortality(18.66% vs. 8.25%) and rehospitalization rate(29.10% vs. 16.49%) of nutritional risk group were significantly higher than those of no nutritional risk group, P=0.026 both. Spearman correlation analysis indicated that cardiac function class were significant positively correlated with plasma BNP level and NRS2002 score(r=0.393,0.802, P=0.001 both), and significant inversely correlated with serum levels of PA, Hb and Alb, BMI and LVEF(r=-0.822^-0.203, P<0.01 all). Conclusion:Nutritional risk status has a significant influence on cardiac function in CHF patients. And cardiac function class is significant positively correlated with serum BNP level and NRS2002 score.