老年综合评估对老年心力衰竭患者日常生活能力、心功能的应用效果

Effectiveness of comprehensive geriatric assessment on ability to perform activities of daily living and cardiac function in elderly patients with heart failure

目的 探究老年综合评估(CGA)对老年心力衰竭患者日常生活能力、心功能的应用效果。方法 回顾性分析老年心力衰竭患者84例临床资料,将采取常规干预方式的患者作为对照组(n=42),在此基础上同时进行CGA的患者作为研究组(n=42),比较两组心功能指标、血清指标浓度、日常生活能力评定量表(ADL)评分、汉密尔顿焦虑量表(HAMA)评分以及心脏不良事件发生情况。结果 干预后,研究组左心室射血分数(LVEF)指标高于对照组,左心室舒张末内径(LVEDD)、左心室收缩末内径(LVESD)指标低于对照组,差异均有统计学意义(t分别=3.06、-3.15、-3.23,P均<0.05);干预后,研究组血清C-反应蛋白(CRP)、氨基末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)及肌酸激酶同工酶(CK-MB)浓度均低于对照组,差异均有统计学意义(t分别=3.26、6.14、3.04、7.06,P均<0.05);干预后,研究组ADL评分高于对照组,HAMA评分低于对照组,差异均有统计学意义(t分别=2.50,-7.20,P均<0.05);研究组心脏不良事件发生率低于对照组,差异有统计学意义(χ~2=4.09,P<0.05)。结论对老年心力衰竭患者进行CGA,能有效改善心功能和血清指标水平,提高患者运动耐力和日常生活能力,缓解焦虑等不良情绪,降低心脏不良事件发生率。

Objective To investigate the application effect of comprehensive geriatric assessment(CGA)on daily liv⁃ing ability and cardiac function of elderly heart failure patients.Methods The clinical data of 84 cases of elderly pa⁃tients with heart failure was retrospectively analyzed.The patients who received conventional intervention were enrolled as the control group(n=42),and the patients who underwent comprehensive geriatric assessment(CGA)at the same time on basis of the conventional intervention were enrolled as the study group(n=42).The cardiac function indexes,serum in⁃dex concentrations,ability to daily living scale(ADL)scores,Hamilton anxiety scores(HAMA),and occurrence of ad⁃verse cardiac events between the two groups were compared.Results After intervention,the LVEF of the study group was higher than that of the control group,while the LVEDD and LVESD were lower than those of the control group,the differences were statistically significant(t=3.06,-3.15,-3.23,P<0.05).After intervention,the serum C-reactive protein(CRP),amino-terminal brain natriuretic peptide precursor(NT-proBNP),cardiac troponin I(cTnI)and creatine kinase isoenzyme(CK-MB)concentrations of the study group were lower than those of the control group(t=3.26,6.14,3.04,7.06,P<0.05).After the intervention,the ADL score of the study group was higher than the control group,while the HA⁃MA score was lower(t=2.50,-7.20,P<0.05).The incidence of adverse cardiac events in the study group was lower than that in the control group(χ2=4.09,P<0.05).Conclusion CGA for elderly patients with heart failure can effectively im⁃prove cardiac function and serum index levels,improve patients'exercise endurance and daily life ability,alleviate anxi⁃ety and other adverse emotions,and reduce the inci⁃dence of adverse cardiac events.