营养风险筛查和个体化营养支持应用于老年慢性心力衰竭患者对心功能的影响
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摘要
目的:探讨营养风险筛查和个体化营养支持对老年慢性心力衰竭(CHF)患者心功能的影响。方法:选取青海省心脑血管病专科医院2017年3月—2018年3月收治的慢性心力衰竭患者168例随机分为观察组和对照组各84例,两组患者均行营养风险筛查,并对高营养风险患者行营养支持,对照组患者在抗心衰基础上给予传统营养支持,观察组患者在抗心衰基础上给予个体化营养支持,观察两组患者营养支持后心功能变化和营养改变情况,观察两组营养过程中胃肠道不良反应,对两组观察指标进行比较。结果:观察组患者存在营养风险共76例,营养风险发生率为90.48%,对照组患者存在营养风险78例,营养风险发生率为92.86%;营养支持后观察组前白蛋白(PA)和白蛋白(ALB)水平明显高于对照组,C-反应蛋白(CRP)指标明显低于对照组(P<0.05),观察组B型钠尿肽(BNP)、左室射血分数(LVEF)以及心排血量(CO)等心功能指标改善情况明显优于对照组,观察组恶心呕吐、腹痛腹胀和腹泻等胃肠道不良反应发生率明显低于对照组(χ2=6.29,P<0.05)。结论:对老年CHF患者行营养风险筛查和个体化营养支持能明显改善患者的心功能,值得在临床推广使用。
Objective To explore and analyze the effects of nutritional risk screening and individualized nutritional support on cardiac function in elderly patients with chronic heart failure(CHF). Method From March 2017 to March 2018,we selected 168 cases of patients with chronic heart failure were randomly divided into observation group and control group with 84 cases each grup,two groups of patients were lines of nutritional risk screening,and line of nutritional support in patients with high nutritional risk,control group on the basis of heart failure patients with traditional nutritional support,the observation group based on heart failure in patients with individualized nutritional support,the change of cardiac function and nutrition change situation after nutritional support in the two groups were observed. The gastrointestinal adverse reactions during nutrition were observed in the two groups. The observation indexes of two groups were compared.Result Among the 84 patients in the observation group,there were 76 nutritional risks,the incidence of nutritional risk was 90. 48%,and 84 patients in the control group had nutritional risk 78 cases,and the incidence of nutritional risk was 92. 86%. After nutritional support,prealbumin(PA) and albumin(propagated) level in the observation group was significantly higher than that of control group,C-reactive protein(CRP) index was significantly lower than the control group(P < 0. 05),the improvement of b-type natriuretic peptide(BNP) and left ventricular ejection fraction(LVEF) and cardiac output(CO) in the observation group was better than the control group,nausea and vomiting,abdominal pain,abdominal distension and diarrhea and other gastrointestinal adverse reactions in the observation group was significantly lower than the control group(χ2= 6. 29,P < 0. 05). Conclusion The nutritional risk screening and individualized nutrition support for the elderly CHF patients can significantly improve the cardiac function of patients,and it is worthy to be used in clinic.
Objective To explore and analyze the effects of nutritional risk screening and individualized nutritional support on cardiac function in elderly patients with chronic heart failure(CHF). Method From March 2017 to March 2018,we selected 168 cases of patients with chronic heart failure were randomly divided into observation group and control group with 84 cases each grup,two groups of patients were lines of nutritional risk screening,and line of nutritional support in patients with high nutritional risk,control group on the basis of heart failure patients with traditional nutritional support,the observation group based on heart failure in patients with individualized nutritional support,the change of cardiac function and nutrition change situation after nutritional support in the two groups were observed. The gastrointestinal adverse reactions during nutrition were observed in the two groups. The observation indexes of two groups were compared.Result Among the 84 patients in the observation group,there were 76 nutritional risks,the incidence of nutritional risk was 90. 48%,and 84 patients in the control group had nutritional risk 78 cases,and the incidence of nutritional risk was 92. 86%. After nutritional support,prealbumin(PA) and albumin(propagated) level in the observation group was significantly higher than that of control group,C-reactive protein(CRP) index was significantly lower than the control group(P < 0. 05),the improvement of b-type natriuretic peptide(BNP) and left ventricular ejection fraction(LVEF) and cardiac output(CO) in the observation group was better than the control group,nausea and vomiting,abdominal pain,abdominal distension and diarrhea and other gastrointestinal adverse reactions in the observation group was significantly lower than the control group(χ2= 6. 29,P < 0. 05). Conclusion The nutritional risk screening and individualized nutrition support for the elderly CHF patients can significantly improve the cardiac function of patients,and it is worthy to be used in clinic.
引文
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[2]陈惠成,龙春梅,陈淑玲.老年慢性心衰重症患者营养状况评估与护理干预[J].齐齐哈尔医学院学报,2013(8):1201-1202.
[3]Sargento L,et al.Nutritional status of geriatric outpatients with systolic heart failure and its prognostic value regarding death or hospitalization,biomarkers and quality of life[J].Nutr Health Aging,2013,17(4):300-304.
[4]潘巍巍,董俊霞,玛黎淸.营养风险筛查及个体化营养支持对老年慢性心力衰竭患者心功能的影响[J].中国慢性病预防与控制,2017,25(11):840-842.
[5]Cabassi A,et al.Prealbumin improves death risk prediction of BNP-added Seattle Heart Failure Model:results from a pilot study in elderly chronic heart failure patients[J].Int JCardiol,2013,168(4):3334-3339.
[6]鲁敏,秦兴雷,孙琳,等.老年慢性心力衰竭患者营养不良与心功能关系[J].中华老年心血管病杂志,2014,16(11):1157-1160.
[7]吴海燕,韦炳华,陈杰.结直肠癌术后患者348张肠外营养处方合理性分析[J].中国药事,2015,29(3):321-324.
[8]韩吉,梁宇,姜明燕.静脉药物调配中心832张全肠外营养处方的综合评价[J].医药导报,2015,34(5):681-684.