老年慢性心力衰竭合并衰弱患者的危险因素分析

Analysis of Risk Factors in Elderly Chronic Heart Failure Patients with Frailty

目的:探讨老年慢性心力衰竭(CHF)合并衰弱患者的相关危险因素。方法:以2020年9月-2021年4月于宜昌市中心人民医院心内科及老年病科住院的65岁以上临床诊断为CHF的138名患者为研究对象,根据衰弱筛查工具FRAIL量表将患者分为衰弱组及非衰弱组。收集两组一般临床资料,分别采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、营养风险筛查表(NRS-2002)评估CHF合并衰弱患者的抑郁、焦虑及营养风险等相关参数。结果:单因素分析显示,与非衰弱组相比,CHF合并衰弱组患者年龄更大、体重指数(BMI)更高、低蛋白血症更明显、合并症更多、心功能更差、抑郁风险更高、焦虑症状更严重、营养不良风险更高。多因素Logistic回归分析结果显示,BMI升高、白蛋白降低、焦虑、抑郁是老年CHF合并衰弱的独立危险因素。结论:BMI、白蛋白、焦虑、抑郁是老年CHF合并衰弱患者的独立预测因子。

Objective:To investigate the related risk factors in elderly chronic heart failure(CHF)patients with frailty.Methods:From September 2020 to April 2021,there were 138 patients over 65 years old with clinical diagnosis of CHF in Yichang Central People's Hospital selected for the further study.According to the frailty screening tool of FRAIL,patients were divided into the frail and the non-frail groups.General clinical data were collected.The Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA)and Nutritional Risk Screening(NRS-2002)Scale were used to evaluate the related parameters of depression,anxiety and nutritional risk in CHF patients with frailty.Results:Univariate analysis showed that the CHF with frail group had older age,higher body mass index(BMI),more obvious hypoalbuminemia,much more comorbidities,worse cardiac function,higher risk of depression,more severe anxiety symptoms,and higher risk of malnutrition,when compared with the non-frail group.Logistic regression analysis suggested that BMI,decreased albumin,anxiety and depression were independent risk factors for frailty in elderly CHF patients.Conclusion:BMI,albumin,anxiety and depression were independent predictors of elderly CHF patients with frailty.