衰弱与慢性心力衰竭

Frailty and chronic heart failure

心力衰竭合并衰弱受到广泛关注。在心力衰竭患者中,衰弱的患病率更高。衰弱和慢性心力衰竭有共同的病理生理机制,主要包括:慢性炎症、衰老、骨骼肌异常和神经内分泌失调。衰弱加重心力衰竭患者的发病风险,影响其预后,所以对慢性心力衰竭患者进行衰弱的评估尤为重要。对于慢性心力衰竭患者的衰弱评估方法尚无统一标准,Fried衰弱标准和衰弱指数是近年研究中应用最广泛的衰弱评估工具,一些简便易行的衰弱筛查工具正在探索中。慢性心力衰竭合并衰弱的干预应从单一的心力衰竭药物治疗转变为多方面的管理,包括营养调整和心肺、心理、躯体功能的整体综合康复。

Frailty associated with heart failure has received widespread attention.The prevalence of frailty is higher in patients with heart failure.Frailty and chronic heart failure share common pathophysiological mechanisms,which are mainly related to chronic inflammation,aging,skeletal muscle abnormalitie and neuroendocrine disorders.Frailty increases the risk of heart failure and affects its prognosis,so it is particularly important to assess frailty in patients with chronic heart failure.There is no unified standard for frailty assessment for patients with chronic heart failure.Fried Phenotype and Frailty Index are the most widely used frailty assessment tools in recent studies,and some convenient frailty screening tools are being explored.The intervention of chronic heart failure combined with frailty should be changed from single drug treatment of heart failure to multi-domain management,including nutrition strategies and comprehensive rehabilitation of cardiopulmonary,psychological and physical functions.