人体成分分析在心力衰竭患者疗效评价中的作用

The role of body composition analysis in evaluating the therapeutic effect of patients with heart failure

目的 调查并分析心力衰竭(HF)患者治疗前后体液分布及营养状况。方法 选取2021年1月至2022年4月该院收治的HF住院患者100例作为研究对象。监测患者治疗前后营养状况水平(血红蛋白、血浆清蛋白、前清蛋白、甘油三酯、总胆固醇等),并由心内科医师对患者进行治疗,由营养科营养师测定患者利尿治疗前(入院治疗第1天)和利尿治疗后(HF纠正、体征消失或减轻,符合出院标准)细胞外液量、细胞内液量(ICW)、全身总液量(TBW)、蛋白质含量、骨骼肌含量、体脂肪、身体细胞量等,并计算ICW/TBW。比较患者治疗前后体液分布及营养状况。结果 100例患者利尿治疗后血红蛋白、血浆清蛋白、前清蛋白、甘油三酯、总胆固醇水平均有所改善,但与治疗前比较,差异均无统计学意义(P>0.05);细胞外液量、TBW、ICW/TBW均呈下降趋势,差异均有统计学意义(P<0.05);ICW、蛋白质含量、骨骼肌含量、体脂肪、身体细胞量与治疗前比较,差异均无统计学意义(P>0.05)。结论 应用利尿剂治疗后可有效改善HF患者体内体液分布水平。但因观察时间较短,对患者营养状况的改善未见明显的干预效果。

Objective To investigate and analyze the body fluid distribution and nutritional status of patients with heart failure(HF) before and after treatment.Methods A total of 100 patients with HF admitted to this hospital from January 2021 to April 2022 were selected as the research objects.The nutritional status of patients(hemoglobin, plasma albumin, prealbumin, triglyceride, total cholesterol, etc.) was monitored before and after treatment, and the patients were treated by cardiologists.Extracellular fluid volume, intracellular fluid volume(ICW),total body fluid volume(TBW),protein content, skeletal muscle content, body fat, body cell volume, etc.,before diuretic treatment(the first day after admission) and after diuretic treatment(HF correction, signs disappearing or alleviating, meeting discharge criteria) were measured by dietitian of nutrition department, and ICW/TBW was calculated.The body fluid distribution and nutritional status of patients before and after treatment were compared.Results The levels of hemoglobin, plasma albumin, prealbumin, triglyceride and total cholesterol of 100 patients were improved after diuretic treatment, but there was no statistical significance compared with before treatment(P>0.05).Both extracellular fluid volume, TBW and ICW/TBW showed a decreasing trend, with statistical significance(P<0.05).There were no significant differences in ICW,protein content, skeletal muscle content, body fat and body cell volume compared with before treatment(P>0.05).Conclusion Diuretic therapy can effectively improve the body fluid distribution in HF patients.However, due to the short observation time, there is no obvious intervention effect on the improvement of nutritional status of patients.