Neutrophil-to-lymphocyte ratio compared to N-terminal pro-brain natriuretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure

Background The neutrophil-to-lymphocyte （N/L） ratio has been associated with poor prognosis in patients with heart failure, but it has not been compared with N-terminal pro-brain natriuretic peptide （NT-proBNP） in elderly patients with chronic heart failure （CHF）. We sought to make this comparison. Methods A total of 1355 elderly patients with CHF were analyzed. A multivariate logistic regression model was used to analyze the variables associated with atrial fibrillation （AF）. Cox regression analysis was used to assess the multivariable rela- tionship between the N/L ratio, NT-proBNP level, and subsequent major cardiovascular events （MCE）. Results In the multiple logistic regression analysis, the N/L ratio was demonstrated as a risk factor for AF in elderly patients with CHF [odds ratio （OR）： 1.079, 95% confi- dence interval （CI）： 1.027-1.134, P = 0.003]. The median follow-up period was 18 months. In a multivariable model using tertiles of both variables, the highest tertile of the N/L ratio was significantly associated with MCE [hazard ratio （HR）： 1.407, 95% CI： 1.098-1.802, P = 0.007] compared with the lowest tertile. Similarly, the highest NT-proBNP tertile was also significantly associated with MCE （HR： 1.461, 95% CI： 1.104-1.934, P- 0.008）. Conclusions In elderly patients with CHF, the N/L ratio is one of the important risk factors for AF and it is an inexpensive and readily available marker with similar independent prognostic power to NT-proBNP. The risk of MCE increases 1.407-fold when the N/L ratio is elevated to the highest tertile.

Additive Benefits of Twice Forest Bathing Trips in Elderly Patients with Chronic Heart Failure

Chronic heart failure （CHF）, a clinical syndrome resulting from the consequences of various cardiovascular diseases （CVDs）, is increasingly becoming a global cause of morbidity and mortality. We had earlier demonstrated that a 4-day forest bathing trip can provide an adjunctive therapeutic influence on patients with CHF. To further investigate the duration of the impact and the optimal frequency of forest bathing trips in patients with CHF, we recruited those subjects who had experienced the first forest bathing trip again after 4 weeks and randomly categorized them into two groups, namely, the urban control group （city） and the forest bathing group （forest）. After a second 4-day forest bathing trip, we observed a steady decline in the brain natriuretic peptide levels, a biomarker of heart failure, and an attenuated inflammatory response as well as oxidative stress. Thus, this exploratory study demonstrated the additive benefits of twice forest bathing trips in elderly patients with CHF, which could further pave the way for analyzing the effects of such interventions in CVDs.

Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.

Effect of adjuvant levosimendan therapy on neuroendocrine hormones and cytokines in elderly patients with chronic heart failure

Objective: To discuss the effect of adjuvant levosimendan therapy on neuroendocrine hormones and cytokines in elderly patients with chronic heart failure. Methods: A total of 100 elderly patients with chronic heart failure who were treated in the hospital between March 2014 and March 2017 were divided into control group and levosimendan group by random number table, each with 50 cases. Control group received clinical routine therapy for chronic heart failure, and levosimendan group received routine therapy combined with adjuvant levosimendan therapy. The differences in serum levels of RAAS indexes, thyroid hormones, myocardial damage indexes and endothelial function indexes were compared between the two groups before and after treatment. Results: At T0, there was no statistically significant difference in serum levels of RAAS indexes, thyroid hormones, myocardial damage indexes and endothelial function indexes between the two groups. At T1, serum RAAS indexes PRA, AngⅡ and ALD levels of levosimendan group were lower than those of control group;serum thyroid hormones TT3, TT4, FT3 and FT4 levels of levosimendan group were higher than those of control group;serum myocardial damage indexes cTnⅠ, H-FABP and NT-proBNP levels of levosimendan group were lower than those of control group;serum endothelial function index NO level of levosimendan group was higher than that of control group while ET-1 level was lower than that of control group. Conclusion: Adjuvant levosimendan therapy for elderly patients with chronic heart failure can effectively adjust the secretion of neuroendocrine hormones and reduce the myocardial and vascular endothelial damage.

Depression and chronic heart failure in the elderly： an intriguing relationship

Chronic heart failure and depressive disorders have a high prevalence and incidence in the elderly. Several studies have shown how depression tends to exacerbate coexisting chronic heart failure and its clinical outcomes and vice versa, especially in the elderly. The negative synergism between chronic heart failure and depression in the elderly may be approached only taking into account the multifaceted pathophysiological characteristics underlying both these conditions, such as behavioural factors, neurohormonal activation, inflammatory mediators, hypercoagulability and vascular damage. Nevertheless, the pathophysiological link between these two conditions is not well established yet. Despite the high prevalence of depression in chronic heart failure elderly patients and its negative prognostic value, it is often unrecognized especially because of shared symptoms. So the screening of mood disorders, using reliable questionnaires, is recommended in elderly patients with chronic heart failure, even if cannot substitute a diagnostic interview by mental health professionals. In this setting, treatment of depression requires a multidisciplinary approach including： psychotherapy, antidepressants, exercise training and electroconvulsive therapy. Pharmacological therapy with selective serotonin reuptake inhibitors, despite conflicting results, improves quality of life but does not guarantee better outcomes. Exercise training is effective in improving quality of life and prognosis but at the same time cardiac rehabilitation services are vastly underutilized.

Heart failure in the elderly

The aging of the population is, currently, a major phenomenon, drawing the attention of a number of investigators. The significant increase of life expectancies over the past few decades, in addition to social and economic consequences, has lead to a major change in the morbidity and mortality profile of elders. Heart failure （HF） is a condition in which the heart can not pump enough blood to meet the body＇s needs. HF is predominantly a disorder of the elderly with rates increasing exponentially. The prevalence of HF approximately doubles with each decade of life. As people live longer, the occurrence of HF rises, as well as other conditions that complicate its treatment. Impaired heart function implies a reduced duration of survival. Fortunately, many factors that can prevent HF and improve outcome are known and can be applied at any stage. This review emphasizes the importance of factors inherent in aging itself, focusing on heart disease, particularly as a disease of aging, can help critically refine management of this acute and chronic disease, as well as foster preventive strategies to reduce the incidence of this common malady.

Effect of Integrated, Person-Centred Palliative Advanced Home and Heart Failure Care on NT-proBNP Levels: A Substudy of the PREFER Study

Objective: In 2012, we initiated a new person-centred model, integrated Palliative advanced home caRE and heart FailurE caRe (PREFER), to integrate specialised palliative home care with heart failure care. Natriuretic peptide-guided treatment is valuable for younger patients (age < 75 years), but its usefulness in palliative care is uncertain. We explored whether patients in PREFER reduced mean level of N-terminal pro B-type natriuretic peptide (NT-proBNP) more than the control group. Design: A pre-specified, exploratory substudy, analysed within the prospective, randomised PREFER study, which had an open, non-blinded design. Participants: Patients in palliative care with chronic heart failure, New York Heart Association class III-IV were randomly assigned to an intervention (n = 36;26 males, 10 females, mean age: 81.9 years) or control group (n = 36;25 males, 11 females, mean age:76.5 years). The intervention group received the PREFER intervention for 6 months. The control group received care as usual at a primary health care centre or heart failure clinic at the hospital. NT-proBNP was measured at the start and end of study. Results: Plasma levels of NT-proBNP differed significantly between groups at baseline. By the end of the study, no significant difference was found between the groups. The mean value for NT-proBNP decreased by 35% in the PREFER group but was not statistically significant (P = 0.074);NT-proBNP increased 4% in the control group. Conclusions: We found no statistically significant reductions of NT-proBNP levels neither between nor within the PREFER and the control group at the end of the study.

基于跨理论模型的焦点式心理干预对老年慢性心力衰竭患者心理韧性及健康行为的影响

目的 观察老年慢性心力衰竭患者采用基于跨理论模型的焦点式心理干预对其心理韧性及健康行为的影响。方法 选择2021年1月至2022年12月黑龙江省大庆龙南医院收治的88例老年慢性心力衰竭患者作为研究对象,按照随机数字表法将其分为对照组与观察组,各44例。对照组采用常规护理,观察组在对照组基础上采用基于跨理论模型的焦点式心理干预。比较两组干预前、干预3个月后心理韧性量表(CD-RISC)评分、健康促进生活方式量表-Ⅱ(HPLP-Ⅱ)评分及护理满意度。结果 干预后,两组CD-RISC总评分、HPLP-Ⅱ总评分及其各维度评分均高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组护理满意度优于对照组,差异有统计学意义(P<0.05)。结论 基于跨理论模型的焦点式心理干预可以有效提高老年慢性心力衰竭患者心理韧性及健康行为水平,且患者满意度更高。

抗阻训练对老年慢性心力衰竭合并衰弱病人的影响

目的:探讨抗阻训练对老年慢性心力衰竭合并衰弱病人的影响。方法:选取2022年1月—8月在南昌大学第二附属医院心内科住院的110例老年慢性心力衰竭合并衰弱病人为研究对象,采用随机数字表法将病人分为对照组50例和试验组60例,对照组采取热身运动、有氧运动(呼吸操)、平衡训练及柔韧运动,试验组在对照组基础上进行抗阻训练(弹力带)。比较两组病人衰弱状况、握力、6 min步行距离(6MWD)。结果:干预后4周及8周试验组衰弱状况均低于对照组(P<0.05),干预后4周及8周试验组握力均高于对照组(P<0.05),干预后4周及8周试验组6MWD均长于对照组(P<0.05)。结论:在热身运动、有氧运动(呼吸操)、平衡训练、柔韧运动基础上联合抗阻训练有利于改善老年慢性心力衰竭合并衰弱病人的衰弱状况,提高病人握力及运动耐力。

中青年慢性心力衰竭患者社会融合现状及影响因素研究

目的调查中青年慢性心力衰竭患者社会融合现状,并分析其影响因素。方法便利选取307例住院中青年慢性心力衰竭患者,采用一般资料调查表、Berkman-Syme社交网络指数、存在无意义焦虑量表、家庭关怀度指数问卷、简化版双向社会支持量表进行调查。结果中青年慢性心力衰竭患者社会融合总分为(6.60±2.26)分,其中社会融合程度Ⅰ级91例(29.64%),Ⅱ级62例(20.20%),Ⅲ级98例(31.92%),Ⅳ级56例(18.24%)。有序多分类logistic回归分析显示,年龄、心衰病程、左室射血分数、合并症指数、存在无意义焦虑、家庭功能、双向社会支持是中青年慢性心力衰竭患者社会融合的影响因素(均P<0.05)。结论中青年慢性心力衰竭患者社会融合程度较低,亟待关注。社会融合受多种因素影响,医护人员应基于可干预因素,制订个性化的提升策略,以促进患者的社会融合,避免社会隔离。

老年慢性心力衰竭患者临床特点分析

目的了解老年慢性心力衰竭(CHF)患者的心力衰竭病因、药物治疗及死亡原因构成情况。方法入选大连市中心医院2002年1月1日至2009年12月31日确诊的老年慢性心力衰竭住院患者518例,对入选患者病因、药物治疗及死亡方式情况进行统计分析。结果老年患者占同期慢性心力衰竭住院患者69.6%。男女比例为1.67:1。入院时(NYHA)心功能分级Ⅲ级(58.6%)和Ⅳ级(28.5%)患者居多。CHF病因构成由高至低依次为冠心病(63.7%),高心病(17.14%),风心病(8.5%)、扩心病(6.2%)。抗心衰药物使用率由高到低分别为:硝酸酯类(86.5%)、利尿剂(74.4%)、洋地黄类(58.6%)、血管紧张素转换酶抑制剂(45.2%),β受体阻滞剂(22.3%)和醛固酮受体拮抗剂螺内酯(20.8%)。死亡原因主要为泵衰竭(52.6%)。结论老年慢性心力衰竭住院患者首位病因为冠心病,硝酸酯类、利尿剂和洋地黄类仍为主要治疗药物,ACEI、β受体阻滞剂在基层医院应用仍不普遍。

美托洛尔治疗中国老年慢性心力衰竭患者的Meta分析

目的评价美托洛尔治疗中国老年慢性心力衰竭的有效性及安全性。方法计算机检索1989年至2012年7月Cochrane图书馆临床对照试验资料库(CCRCT)、Pubmed、Embase、万方数据库、中国学术期刊全文数据库(CNKI)、维普数据库(VIP),收集美托洛尔治疗老年心力衰竭的随机对照试验(RCT),按纳入和排除标准由2名评价者独立选择试验、提取资料,交叉核对并进行方法学质量评估,使用RevMan5.0软件进行Meta分析。结果共纳入9项研究,760例患者。结果显示,常规治疗基础上联用美托洛尔治疗老年慢性心力衰竭显著优于常规治疗对照组(RR=1.23,95%CI:1.15～1.32,P<0.001);联用美托洛尔可降低左室舒张末期内径(LVEDD)(WMD=-5.94,95%CI:-6.83～-5.03,P<0.001);增加左室射血分数(LVEF)(WMD=5.81,95%CI:4.86～6.76,P<0.001);但同时造成不良反应发生率增加(RR=10.17,95%CI:3.92～26.37,P<0.001),主要包括胸闷、乏力、头晕、双下肢水肿、心动过缓、房室传导阻滞等。结论现有证据显示联合美托洛尔治疗可改善老年慢性心力衰竭临床疗效及心功能指标,但会使不良反应增加,应采取个体化治疗。受纳入文献质量的限制,美托洛尔治疗老年心力衰竭的疗效和安全性期待更多高质量的随机对照双盲研究,以做进一步的评价。

无创血流动力学监测可用于对老年慢性心力衰竭患者心功能的评价

目的通过对老年慢性心力衰竭患者无创血流动力学监测,并与美国纽约心脏病学会(NYHA)心功能分级做对比分析,初步评价判定心功能分级的可靠性。方法选取我院自2004年4月～2005年9月1日收治于老年心血管病科的冠心病、高血压病、扩张型心肌病等患者共120例,按NYHA分级分为Ⅰ、Ⅱ、Ⅲ、Ⅳ共4组,应用Bioz.com无创血流动力学监测得到16种血流动力学参数,进行统计学分析。结果①心输出量(CO)、心排血指数(CI)、左室每博作功指数(LVSWI)、左心作功指数(LCWI)4项参数值按NYHA分级Ⅰ～Ⅳ组有逐渐减低趋势(P<0.05);②每博输出量(SV)、每博输出指数(SI)、速率指数(VI)按NYHA分级Ⅰ、Ⅱ组间,Ⅲ、Ⅳ组间无显著差异,但Ⅰ、Ⅱ组与Ⅲ～Ⅳ组间有明显减低趋势(P<0.05);外周阻力(SVR)、外周阻力指数(SVRI)按NYHA分级Ⅰ、Ⅱ组间,Ⅲ、Ⅳ组间无显著差异,但Ⅰ、Ⅱ组与Ⅲ、Ⅳ组间有明显增高趋势(P<0.05);③胸部液体含量(TFC)、收缩时间比率(STR)按NYHA分级Ⅰ、Ⅱ、Ⅲ组间无显著差异,但Ⅳ组与其他各组比较有明显增高趋势(P<0.05)。结论无创血流动力学监测到的血流动力学参数可作为评估慢性心力衰竭临床分级标准的量化指标。

口服营养补充在老年慢性心力衰竭合并营养不良患者中的应用

目的探讨口服营养补充(ONS)在老年慢性心力衰竭合并营养不良患者中的应用效果。方法 90例老年慢性心力衰竭合并营养不良患者随机分为对照组和实验组,各45例。对照组常规营养支持和护理,实验组在对照组基础上给予ONS。对比治疗前后2组血清脑钠肽(BNP)、左室射血分数(LVEF)和相关营养指标变化。结果治疗后2组患者BNP水平下降,LVEF上升,与治疗前比较差异有统计学意义(P<0.05),但2组改善幅度差异无统计学意义(P>0.05)。治疗后2组血清前清蛋白(PA)、转铁蛋白(TRF)均较治疗前上升,且实验组PA、TRF水平高于对照组,差异有统计学意义(P<0.05)。实验组并发症例数低于对照组,但差异无统计学意义(P>0.05)。结论 ONS应用于老年慢性心衰合并营养不良患者临床疗效显著,可改善患者营养状况,对辅助治疗、缓解心衰症状具有积极意义。

多元文化护理对新疆地区不同少数民族老年慢性心力衰竭患者自我管理水平及生活质量的影响

目的 探讨多元文化护理对新疆地区不同少数民族老年慢性心力衰竭(CHF)患者自我管理水平及生活质量的影响。方法选择新疆地区不同少数民族老年CHF患者204例为研究对象,随机分为观察组与对照组,每组102例。对照组采用常规护理,观察组采用多元文化护理。比较两组患者自我管理水平及生活质量。结果观察组患者饮食管理、症状管理、药物管理、心理与社会适应管理评分及自我管理水平总分均高于对照组,体力限制、情绪、社会限制、症状评分及生活质量总分均低于对照组(均P<0.05)。结论多元文化护理有助于提高新疆地区不同少数民族老年CHF患者的自我管理水平及生活质量。

老年心力衰竭急性加重住院病人临床特点分析

目的探讨老年心力衰竭急性加重病人住院的临床特点,为老年心力衰竭急性加重的防治提供理论依据。方法回顾性分析2017年1月-2017年12月住院急性心力衰竭病人的临床资料,收集65岁及以上病人且以80岁为界,分为高龄组和老年组进行分析。共纳入3914例老年急性心力衰竭住院病人,其中老年组1602例,高龄组2312例。结果两组年龄、男性、住院天数、死亡率、住院费用比较差异均有统计学意义(P<0.05)。老年组前5位住院原因分别是高血压病(18.3%)、慢性阻塞性肺疾病急性发作(13.4%)、冠状动脉粥样硬化性心脏病(12.4%)、脑卒中(7.8%)、其他类型心脏病(6.2%)。高龄组前5位住院原因分别为慢性阻塞性肺疾病急性发作(15.9%)、冠状动脉粥样硬化性心脏病(13.6%)、高血压病(12.2%)、肺炎(7.7%)、脑卒中(6.7%)。结论慢性阻塞性肺疾病急性发作是导致老年特别是高龄病人心力衰竭急性加重入院的重要原因。

氯沙坦与苯那普利治疗老年慢性心功能不全的研究

目的 观察氯沙坦与苯那普利对老年慢性心功能不全 (CHF)的作用 ,探讨两者在老年CHF治疗中的地位。方法 共 13 5例患者入选 ,年龄均大于 60岁 ,心功能在Ⅱ～Ⅳ级之间 ,经心脏彩色多普勒超声检查证实左室射血分数在 5 0 %以下。在原有抗心力衰竭的基础上随机分入氯沙坦组 (2 5～ 5 0mg d)以及苯那普利组 (5～ 10mg d)。在治疗前及治疗后第 1、3、7、12周查血钾、肾功能及心电图。治疗前及治疗后第 12周时测定患者心脏结构和功能的变化。结果 苯那普利组和氯沙坦组治疗后第 12周时LVEDD(5 .97± 0 .41vs 6.3 6± 0 .43 ;5 .91± 0 .44vs 6.3 2± 0 .41)、LVEF(3 6.4± 4.3vs 3 0 .2± 4.9;3 7.8± 5 .1vs 2 9.7± 4.6)、CO(4 .62± 1.95vs 3 .3 5± 1.67;4.67± 1.82vs 3 .2 8± 1.72 )较入院时明显改善。但两组之间相比无显著差异。苯那普利组患者中共有 16例 (2 3 .19% )出现咳嗽、高钾血症、皮疹、局部血管神经性水肿等不良反应 ,氯沙坦组中仅有 1例 (1.5 % )患者出现低血压。结论 (1)氯沙坦及苯那普利均可以在一定程度上逆转老年CHF患者的左室重构 ,但两组之间相比无显著差异。 (2 )服用氯沙坦患者中咳嗽等不良反应发生率要明显低于苯那普利 ,耐受良好。

血管性血友病因子检测在老年慢性心力衰竭患者并发下肢静脉血栓中的临床意义

目的分析血管性血友病因子(vWF)对老年慢性心力衰竭(CHF)患者发生下肢静脉血栓的预测价值。方法选取96例老年CHF患者,以其中37例合并下肢静脉血栓的患者为疾病研究组,59例未合并下肢静脉血栓的患者为疾病对照组,另选取50名>60岁的体检健康者为正常对照组。收集96例老年CHF患者一般临床资料,检测所有研究对象vWF活性、D-二聚体、凝血功能等指标。采用Logistic回归分析评价CHF并发下肢静脉血栓的影响因素。采用受试者工作特征(ROC)曲线评估血浆vWF活性诊断老年CHF患者发生下肢静脉血栓的效能。结果与疾病对照组比较,疾病研究组vWF活性显著升高(P<0.05)。Logistic回归分析结果显示,vWF活性是CHF患者并发下肢静脉血栓的风险因素。以231.5%为最佳临界值,血浆vWF活性诊断老年CHF并发下肢静脉血栓的敏感性为78.6%,特异性为82.6%。结论血浆vWF活性对评估老年CHF患者并发下肢静脉血栓风险有一定的临床价值。

自拟强心汤治疗老年慢性心力衰竭疗效分析

目的：探讨自拟强心汤联合西药治疗老年慢性心力衰竭的疗效。方法：研究病例来源于2013年10月~2015年5月期间我院收治的老年慢性心力衰竭患者86例,依据随机数字表法随机分为观察组、对照组各43例。对照组采用常规西医治疗,观察组在对照组基础上结合自拟强心汤治疗,疗程均为4周。观察两组临床疗效,比较两组治疗前后LVEF、LVEDD、BNP、IL-6、TNF-α、hs-CRP、6MWT变化及不良反应发生情况。结果：观察组总有效率（89.70%）高于对照组（69.77%）（P〈0.05）;两组LVEF治疗后明显增加,而LVEDD、BNP水平治疗后明显下降（P〈0.05）;观察组LVEF高于对照组,LVEDD、BNP低于对照组（P〈0.05）;两组血清IL-6、TNF-α、hs-CRP水平治疗后明显降低（P〈0.05）;观察组血清IL-6、TNF-α、hs-CRP水平治疗后低于对照组（P〈0.05）;两组6MWT治疗后明显增加（P〈0.05）;观察组6MWT治疗后多于对照组（P〈0.05）;两组均未见严重用药不良反应。结论：自拟强心汤联合西药治疗老年慢性心力衰竭的疗效显著,具有重要研究价值。

护理干预在减少老年慢性心力衰竭反复发作中的应用

目的探讨护理干预对老年慢性心力衰竭患者的反复发作的预防效果。方法选取80例老年慢性心力衰竭衰竭患者为研究对象,随机分为观察组和对照组各40例。对照组采用常规护理模式,观察组对患者服药依从性,睡眠,情绪进行护理干预。随访6个月,比较两组患者睡眠质量,焦虑、抑郁评分及心力衰竭复发情况。结果观察组PSQI,SAS,SDS评分改善情况显著优于对照组(P<0.05)。6个月随访期间观察组治疗完全遵从比例高于对照组(P<0.05)。观察组心衰复发人数显著低于对照组(P<0.05)。结论护理干预可改善老年慢性心力衰竭患者的睡眠质量,降低焦虑、抑郁评分,有效提高治疗依从性,降低慢性心力衰竭复发。