微营养素测定在老年慢性心力衰竭合并衰弱患者中的临床意义

Clinical significance of micronutrients determination in elderly patients with chronic heart failure accompanied with frailty

目的探讨微营养素在老年慢性心力衰竭合并衰弱患者中水平及其临床意义。方法选取住院46例老年慢性心力衰竭患者(年龄≥70岁,NYHA心功能分级在Ⅱ—Ⅲ级),收集相关资料包括一般情况、慢性疾病、用药史及衰弱评分量表。采集相关血标本测定微营养素浓度。以门诊参加体检的无心力衰竭病史或症状的老年人为健康对照组。结果与对照组相比,无论是心力衰竭或心力衰竭合并衰弱组的血清镁、血清钙、血清铁、维生素B12以及25-羟维生素D[25-(OH) D]的浓度明显低于健康对照组(P <0. 05)。其中心力衰竭合并衰弱组的25-(OH) D的浓度明显低于心力衰竭组(P <0. 05)。logistic回归分析显示25-(OH) D(降低)是心力衰竭合并衰弱的危险影响因素(P <0. 05)。结论老年慢性心力衰竭患者易发生部分微营养素的不足或缺乏,其中维生素D水平的低下与衰弱的发生有相关性。

Objective To investigate the clinical significance of micronutrients detect in elderly patients with chronic heart failure merged with frailty. Methods A total of 46 elderly chronic heart failure( NYHA grade Ⅱ-Ⅲ level) patients aged 70 and over were enrolled. The information on demographic characteristics,chronic diseases and medication history were collected. All considered patients underwent Fried criteria. Blood samples were collected to determine the level of mincronutritions. The elderly patients without heart failure histories who underwent routine physical examinations in our hospital were in normal control group. Results Compared with the control group,the serum magnesium,serum calcium,serum iron,vitamin B12 and 25-( OH) Vit D concentrations in heart failure group or heart failure combined with asthenia group were significantly lower than those in the normal control group. The concentration of 25-( OH) Vit D in the group of heart failure combined with frailty was significantly lower than that in the heart failure group. Logistic regression analysis showed that 25-( OH) Vit D deficiency was independently associated with frailty. Conclusion Elderly patients with chronic heart failure are prone to have partial micronutrient deficiencies,the decreased vitamin D level is related to the occurrence of weakness.