老年营养风险指数对慢性心肾综合征患者预后评估的价值分析

Value of Geriatric Nutritional Risk Index in Prognosis Evaluation of Patients with Chronic Cardiorenal Syndrome

目的:探讨老年营养风险指数(GNRI)对慢性心肾综合征(CRS)患者预后评估的价值分析。方法:选择2017年9月—2019年6月间在我院就诊的83例慢性CRS患者作为研究对象,计算患者的GNRI,以患者随访1年期间是否发生心血管不良定义为预后不良。观察患者GNRI和其他临床资料与患者预后不良的关系。结果:不同预后患者GNRI指数存在统计学差异(P <0.05)。预后不良和预后良好患者性别、年龄、原发病和风险因素(冠心病、瓣膜病、扩张型心肌病、肺源性心脏病)等相比较差异均无统计学意义(P>0.05),预后不良组收缩压、舒张压、心功能分级、NT-proBNP、Scr、尿酸、Cys C水平高于预后良好组(P <0.05),预后不良组体质量指数、GFR、LVEF、白蛋白均低于预后良好组(P <0.05)。多因素Logistic分析显示,中高营养风险是预后不良的风险因素(P <0.05),其他风险因素包括NT-proBNP、Cys C (P <0.05),保护性因素包括LVEF (P <0.05)。结论:GNRI与CRS患者预后相关,在预测CRS患者预后方面具有重要价值,值得临床推广应用。

[Objective] To investigate the value of geriatric nutritional risk index (GNRI)in evaluating the prognosis of patients with chronic cardiorenal syndrome (CRS).[Method] Totally 83 patients with chronic CRS from September 2017 to June 2019 in our hospital were selected as the research objects,and their GNRI was calculated.Adverse prognosis was defined as whether the patients had cardiovascular adverse events during one year follow-up.The relationship between GNRI and other clinical datas and poor prognosis was observed.[Result] There were significant differences in GNRI index among different prognosis patients (P <0.05).There were no significant differences in gender,age,primary disease and risk factors (coronary heart disease,valvular disease,dilated cardiomyopathy,pulmonary heart disease)between poor and good prognosis patients (P>0.05).Systolic blood pressure,diastolic blood pressure,cardiac function classification,NT proBNP,SCR,uric acid,CysC levels in poor prognosis group were higher than those in good prognosis group (P <0.05),and body mass index,GFR,LVEF and albumin in poor prognosis group were lower than those in good prognosis group (P <0.05).Multivariate logistic analysis showed that medium and high nutritional risk was the risk factor of poor prognosis (P <0.05),other risk factors included NT proBNP and CysC (P <0.05),and protective factors included LVEF (P <0.05).[Conclusion] GNRI is related to the prognosis of CRS patients,and it has important value in predicting the prognosis of CRS patients,which is worthy of clinical application.