先天性心脏病患儿营养状况及其危险因素分析

Nutritional Status in Children with Congenital Heart Disease and It s Influential Factors

目的研究先天性心脏病患儿营养不良的发生率及危险因素。方法分析2018年1月—2019年12月在云南省阜外心血管病医院手术的334例先天性心脏病患儿(年龄1~7岁)的临床资料,收集身高和体重等信息。根据WHO的标准,采用Z评分评价先天性心脏病患儿的营养状况,分析发生营养不良的危险因素。结果生长迟缓、低体重和消瘦三种营养不良情况分别占19.8%、8.4%和25.3%。与低体重相关的危险因素包括:心力衰竭(OR=12.361,P<0.001)、肺动脉高压(OR=2.398,P=0.012)、肺炎(OR=8.153,P=0.001)和低出生体重(OR=2.115,P=0.003)。生长迟缓的危险因素包括心力衰竭(OR=4.831,P<0.001)和肺动脉高压(OR=2.699,P=0.038)。消瘦的主要相关因素为肺动脉高压(OR=5.091,P<0.001)、肺炎(OR=8.462,P=0.001)和心力衰竭(OR=5.381,P=0.003)。结论先天性心脏病患儿营养不良的发生率较高。心力衰竭、肺动脉高压和肺炎是发生营养不良的危险因素。

Objective To investigate the nutritional condition and identify the risk factors of malnutrition in the children with congenital heart disease.Methods We analyzed the clinica1 data of 334 children with congenital heart disease(aging 1~7)that underwent operation between January 2018 to December 2019 in our institution.Detailed anthropometry was performed.According to the standards of WHO,the Z scores was used to assess the nutritional condition for the children.Chi square test and logistic regression analysis were used to identify the risk factors of malnutrition.Results Growth retardation,low body weight and wasting represented the poor nutritional conditions,which accounted for 19.8%,8.4%and 25.3%,respectively.Heart failure(OR=12.361,P<0.001),pulmonary hypertension(OR=2.398,P=0.012),pneumonia(OR=8.153,P=0.001)and low birth weight(OR=2.115,P=0.033)were significant correlation with lower body weight.The risk factor of growth retardation included heart failure(OR=4.831,P<0.001)and pulmonary hypertension(OR=2.699,P=0.038).For wasting,pulmonary hypertension(OR=5.091,P<0.001),pneumonia(OR=8.462,P=0.001)and heart failure(OR=5.381,P=0.003)were the main relevant factors.Conclusion The poor nutritional condition is not uncommon in the children with congenital heart disease.Heart failure,pulmonary hypertension and pneumonia are the risk factors of malnutrition.