不同射血分数慢性心衰患者营养不良风险调查及影响因素分析

Investigation of Risk of Malnutrition in CHF Patients with Different Ejection Fractions and Analysis on Influencing Factors

目的调查不同射血分数类型慢性心衰患者存在营养不良风险的情况,并分析相关影响因素。方法以2020年8-12月收治于衡阳市某三级甲等医院心内科的慢性心衰患者作为调查对象,采用一般资料调查问卷、营养风险筛查量表(NRS-2002)进行调查及评估。结果共调查患者329例,存在营养不良风险者155例,占47.11%。其中,射血分数降低组患者中存在营养不良风险者占57.71%,高于射血分数中间值组(37.50%)和射血分数保留组(32.93%)。logistic回归分析显示,年龄≥70岁、N末端B型利钠肽前体(NT-proBNP)及射血分数<40%均是慢性心衰营养不良风险的影响因素(P<0.05),淋巴细胞数值是其保护性因素(P<0.05)。结论慢性心衰患者存在较高的营养不良风险,其中射血分数降低的患者营养不良风险更高。临床护理工作中,应对年龄≥70岁、射血分数<40%及NT-proBNP升高的慢性心衰患者实施有针对性的营养评估,以及时发现患者的营养问题并进行干预,促进患者预后改善和生活质量提升。

Objective different ejection fractions and to analyze the influencing factors.MethodsCHF patients admitted to the Cardiology Department of a gradeⅢ-A hospital in Hengyang City from August to December 2020 were selected.They were investigated and evaluated using the General Information Questionnaire and the Nutrition Risk Screening(NRS-2002).ResultsA total of 329 patients were investigated,and 155(47.11%)were at risk of malnutrition.Among them,57.71%of the patients with reduced ejection fraction were at risk of malnutrition,higher than the proportion of those with intermediate ejection fraction(37.50%)and unchanged ejection fraction(32.93%).Logistic regression analysis showed that age≥70 years,N-terminal pro-brain natriuretic peptide(NT-proBNP)and ejection fraction<40%were influencing factors for the risk of malnutrition in CHF patients(P<0.05),while lymphocyte count was a protective factor(P<0.05).ConclusionCHF patients are at high risk of malnutrition,and those with reduced ejection fraction have a higher risk.In clinical care,targeted nutritional assessment is necessary for the CHF patients aged≥70 years,with ejection fraction<40%and elevated NT-proBNP,in order to identify nutritional problems and take interventions in time,improving their prognosis and quality of life.