营养状况与老年女性慢性心力衰竭生存质量相关性研究

目的探讨老年女性慢性心力衰竭(CHF)患者生存质量与营养状况的相关性。方法选取老年女性CHF患者120例,按照心功能分级(NYHA)分为Ⅱ级组34例、Ⅲ级组54例、Ⅳ级组32例,另选取老年女性健康体检者30例为对照组。收集各组血清血红蛋白、淋巴细胞绝对值,进行微型营养评定量表(MNA)和明尼苏达心力衰竭生存质量量表(MLHFQ)评分。结果Ⅱ级组、Ⅲ级组、Ⅳ级组患者存在营养不良风险和营养不良的总发生率明显高于对照组(67.7%,81.5%,100.0%vs 33.3%,P<0.01)。Ⅱ级组、Ⅲ级组、Ⅳ级组白蛋白和MNA评分及Ⅲ级组、Ⅳ级组血红蛋白水平明显低于对照组,外周水肿深度明显高于对照组(P<0.05)。Ⅳ级组外周水肿深度明显高于Ⅱ级组及Ⅲ级组,血红蛋白和MNA评分明显低于Ⅱ级组及Ⅲ级组(P<0.05)。MNA评分和外周水肿深度与MLHFQ评分相关(P<0.01)。MLHFQ评分与住院天数呈正相关(r=0.327,P<0.01)。结论老年女性CHF患者营养不良问题普遍存在。MNA评分和外周水肿深度对预测老年女性CHF患者生存质量有重要意义。

Relationship between nutritional status and quality of life in elderly female CHF patients

Objective To study the relationship between nutritional status and quality of life in elderly female CHF patients.Methods One hundred and twenty elderly femal CHF patients were divided into cardiac function Ⅱ group(n=34),cardiac function Ⅲ group(n=54) and cardiac function Ⅳ group(n=32) according to the NYHA with 30 elderly females undergoing physical examination served as a control group.The serum hemoglobin level was measured and the absolute value of lymphocytes was calculated.The nutritional status and quality of life were scored by the MNA scale and MLHFQ scale.Results The total incidence of malnutrition was significantly higher in cardiac function Ⅱ,Ⅲ and Ⅳ groups than in control group(67.7%,81.5%,100.0% vs 33.3%,P<0.01).The serum albumin levels and the MNA scale score were significantly lower while the peripheral edema depth was significantly longer in cardiac function Ⅱ,Ⅲ and Ⅳ groups than in control group(P<0.05).The serum hemoglobin level was significantly lower in cardial function Ⅲ and Ⅳ groups than in control group.The peripheral edema depth was significantly longer while the serum hemoglobin level and MNA scale score were significantly lower in cardiac function Ⅳ group than in cardiac functionⅡand Ⅲ groups(P<0.05).The MNA scale score and peripheral edema depth were the main influencing factors of MLHFQ scale score(P<0.01).The MLHFQ scale score was positively related with the hospital stay days(r=0.327,P<0.01).Conclusion Malnutrition is common in elderly female CHF patients.Peripheral edema depth and MNA scale score are the important predictors of quality of life in elderly female CHF patients.