体重管理干预对慢性心力衰竭患者血清氨基末端脑钠肽前体水平、焦虑情绪和生活质量的影响

Effects of weight management intervention on levels of serum N-terminal pro-brain natriuretic peptide,anxiety and quality of life in patients with chronic heart failure

目的探究体重管理干预模式对慢性心力衰竭(CHF)患者血清氨基末端脑钠肽前体(NT-proBNP)水平、焦虑情绪和生活质量的影响。方法选取2017年3月至2018年3月成都市第五人民医院收治的CHF患者92例,随机分成观察组和对照组,每组46例,两组患者均接受常规治疗,观察组在常规治疗基础上采用体重管理干预模式。比较两组患者体重变化、NT-proBNP水平、汉密尔顿焦虑量表(HAMA)、抑郁量表(HAMD)和生活质量综合评定问卷(GQOLI-74)评分;并记录治疗期间不良心血管事件(MACE)。结果治疗前,两组患者平均体重、血清中NT-proBNP水平、HAMA、HAMD量表评分及GQOLI-74评分比较差异无统计学意义(P>0.05)。观察组患者治疗后3个月和6个月的体重明显低于对照组(t=10.786、13.808,P<0.05);观察组患者治疗后1个月、3个月和6个月的NT-proBNP水平明显低于对照组,(t=2.085、66.277、28.697,P<0.05);观察组患者治疗后3个月和6个月的HAMA、HAMD量表评分明显低于对照组(t=5.040、12.689、14.271、13.750,均P<0.05);观察组患者治疗后GQOLI-74各项评分均优于对照组(t=21.248、22.235、18.328、23.107,P<0.05)。治疗期间,与观察组相比,对照组发生主要不良心血管事件的风险明显增加(χ^(2)=6.214,P<0.05)。结论体重管理干预模式可以明显降低老年CHF患者的血清NT-proBNP水平,减少患者负面情绪和不良心血管事件的发生,提高患者生活质量。

Objective To explore the effect of weight management intervention model on levels of serum N-terminal pro-brain natriuretic peptide(NT-proBNP),anxiety and quality of life in patients with chronic heart failure(CHF).Methods 92 patients with CHF admitted to Chengdu fifth people’s hospital from March 2017 to March 2018 were selected and randomly divided into observation group and control group,with 46 cases in each group.Patients in both groups received routine treatment,and weight management intervention mode was adopted in the observation group on the basis of routine treatment.Weight changes,levels of NT-proBNP and scores of Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)and general quality of life inventory-74(GQOLI-74)were compared between the two groups.Major adverse cardiovascular events(MACE)during treatment were recorded.Results Before treatment,there was no statistically significant difference between the two groups in average weight,levels of serum NT-proBNP and scores of HAMA,HAMD scale and GQOLI-74(P>0.05).The body weight of the patients in the observation group at 3 and 6 months after treatment was significantly lower than those in the control group(t=10.786,13.808;P<0.05).The levels of NTproBNP at 1,3 and 6 months after treatment in the observation group was significantly lower than those in the control group(t=2.085,66.277,28.697;P<0.05).HAMA and HAMD scores at 3 and 6 months after treatment in the observation group were significantly lower than those in the control group(t=5.040,12.689,14.271,13.750;all P<0.05).The GQOLI-74 scores in the observation group were significantly better than those in the control group after treatment(t=21.248,22.235,18.328,23.107;P<0.05).During treatment,the risk of major adverse cardiovascular events was significantly increased in the control group compared to the observation group(χ^(2)=6.214,P<0.05).Conclusion The intervention model of weight management can significantly reduce the level of serum N T-pro BNP,reduce the occurrence of negative emotions and MACE,and improve the quality of life of patients with CHF.