| 金 迪,全静雯,蒋孟柳,慕容敏,梁伟芬.老年心力衰竭患者营养不良的影响因素分析及早期肠内营养对营养不良患者心功能、营养状况和肠道黏膜屏障功能的影响[J].,2022,(24):4669-4673 |
| 老年心力衰竭患者营养不良的影响因素分析及早期肠内营养对营养不良患者心功能、营养状况和肠道黏膜屏障功能的影响 |
| Analysis of Influencing Factors of Malnutrition in Elderly Patients with Heart Failure and the Effect of Early Enteral Nutrition on Cardiac Function, Nutritional Status and Intestinal Mucosal Barrier Function in Patients with Malnutrition |
| 投稿时间：2022-05-28 修订日期：2022-06-23 |
| DOI：10.13241/j.cnki.pmb.2022.24.013 |
| 中文关键词: 老年 心力衰竭 营养不良 早期肠内营养 心功能 营养状况 肠道黏膜屏障功能 |
| 英文关键词: Elderly Heart failure Malnutrition Early enteral nutrition Cardiac function Nutritional status Intestinal mucosal barrier function |
| 基金项目:广东省自然科学基金项目（2017A035313606） |
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| 中文摘要: |
| 摘要 目的：探讨老年心力衰竭（HF）患者营养不良的影响因素及早期肠内营养对营养不良患者心功能、营养状况和肠道黏膜屏障功能的影响。方法：选取2021年2月~2022年4月期间在我院接受治疗的180例老年HF患者作为研究对象。入院后采用微型营养评价简表（MNA-SF）评估患者的营养状况。根据MNA-SF评分结果分为营养不良组（n=83）和营养正常组（n=97）。应用单因素及多因素Logistic回归分析老年HF患者营养不良的危险因素。对老年HF营养不良患者给予早期肠内营养干预，观察其治疗前、治疗一周后心功能、营养状况和肠道黏膜屏障功能的变化情况。结果：老年HF患者营养不良与性别、居住地、饮酒史、病因、职业类别、谷丙转氨酶、血肌酐、收缩压（SBP）、舒张压（DBP）无关（P>0.05），而与年龄、医保类型、病程、婚姻状况、美国纽约心脏病学会（NYHA）分级、文化程度、C反应蛋白（CRP）、家庭人均月收入、B型脑钠肽（BNP）、吸烟史、左心室射血分数（LVEF）有关（P<0.05）。Logistic回归分析结果显示：病程偏长、CRP偏高、BNP偏高、NYHA分级为IV级、年龄偏大、吸烟史是老年HF患者发生营养不良的危险因素（P<0.05）。治疗1周后，营养不良组老年HF患者的LVEF升高，BNP下降（P<0.05）。治疗1周后，营养不良组老年HF患者的前白蛋白（PA）、转铁蛋白（TRF）升高（P<0.05）。治疗1周后，营养不良组老年HF患者的D-乳酸（D-Lac）、二胺氧化酶（DAO）、肠脂肪酸结合蛋白（IFABP）下降（P<0.05）。结论：老年HF患者营养不良受到病程、CRP、BNP、NYHA分级、年龄、吸烟史等多种因素的影响，针对老年HF患者营养不良给予早期肠内营养，有助于改善患者心功能、营养状况和肠道黏膜屏障功能。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the influencing factors of malnutrition in elderly patients with heart failure (HF) and the effects of early enteral nutrition on cardiac function, nutritional status and intestinal mucosal barrier function in patients with malnutrition. Methods: 180 elderly patients with HF who were treated in our hospital from February 2021 to April 2022 were selected as the research objects. After admission, the nutritional status of all patients was evaluated according to the short-form mini-nutritional assessment (MNA-SF). According to the MNA-SF score results, they were divided into malnutrition group (n=83) and normal nutrition group (n=97). Univariate and multivariate Logistic regression were used to analyze the risk factors of malnutrition in elderly patients with HF. The elderly patients with HF malnutrition were given early enteral nutrition intervention, and the changes situation of cardiac function, nutritional status and intestinal mucosal barrier function were observed before treatment and 1 week after treatment. Results: There were no significant correlation between malnutrition in elderly patients with HF and gender, residence, drinking history, etiology, occupational category, glutamic-pyruvic transaminase, serum creatinine, systolic blood pressure (SBP) and diastolic blood pressure (DBP) (P>0.05), and were associated with age, medical insurance type, disease course, marital status, New York Heart Association (NYHA) classification, educational level, C-reactive protein (CRP), family per capita monthly income, B-type brain natriuretic peptide (BNP), smoking history, left ventricular ejection fraction (LVEF) (P<0.05). Logistic regression analysis showed that longer disease course, higher CRP, higher BNP, NYHA classification IV, older age and smoking history were risk factors for malnutrition in elderly patients with HF (P<0.05). 1 week after treatment, LVEF was increased in elderly patients with HF with malnutrition group, and BNP was decreased (P<0.05). 1 week after treatment, the levels of prealbumin (PA) and transferrin (TRF) in elderly patients with HF in the malnutrition group were increased (P<0.05). 1 week after treatment, D-lactic acid (D-LAC), diamine oxidase (DAO) and intestinal fatty acid binding protein (IFABP) in elderly patients with HF in the malnutrition group were decreased (P<0.05). Conclusion: Malnutrition in elderly patients with HF is affected by the disease course, CRP, BNP, NYHA classification, age, smoking history and other factors. Early enteral nutrition for elderly patients with HF malnutrition is helpful to improve their cardiac function, nutritional status and intestinal mucosal barrier function. |
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