老年综合评估对老年慢性心力衰竭病人心功能及生活质量的影响

目的观察老年综合评估(comprehensive geriatric assessment,CGA)对老年慢性心力衰竭(chronic heart failure,CHF)病人心功能及生活质量的影响。方法选取60岁以上的CHF病人102例,随机分为干预组(n=51)和对照组(n=51)。2组均给予指南指导下的药物治疗。干预组在药物治疗基础上同时进行CGA和多学科干预指导治疗。比较2组病人治疗3、6、12个月后纽约心脏病协会(NYHA)心功能分级、左心室射血分数(LVEF)、6 min步行距离(6MWD)、血浆B型脑钠肽(BNP)水平、明尼苏达心功能不全生命质量量表(MLHFQ)评分的变化。结果干预组治疗3、6、12个月后,LVEF、6MWD较治疗前显著提高,而BNP水平和MLHFQ评分显著下降,差异均有统计学意义(P<0. 01);治疗12个月后,干预组LVEF、6MWD、BNP、心功能NYHA分级及MLHFQ评分均较对照组明显改善,差异有统计学意义(P<0. 05或P<0. 01)。结论 CGA对于提高老年CHF病人的心功能和生活质量有积极影响。

Effect of comprehensive geriatric assessment on cardiac function and quality of life in the elderly patients with chronic heart failure

Objective To observe the effect of comprehensive geriatric assessment(CGA) on cardiac function and quality of life in the elderly patients with chronic heart failure (CHF).Methods A total of 102 patients with CHF aged 60 and over were enrolled and randomly divided into intervention group and control group,with 51 cases in each group. Both groups were given drug treatment according to the treatment guideline.The intervention group was given CGA and multidisciplinary interventions based on the drug treatment. New York Heart Association (NYHA) cardiac functional grading, left ventricular ejection fraction (LVEF), six-minute walking distance (6MWD),level of brainnatriuretic peptide(BNP) and score of Minnesota living with heart failure questionnaire(MLHFQ) in two groups were observed and compared before and 3,6,12 months after treatment.Results LVEF,6MWD in intervention group were significantly increased,while the level of BNP and the score of MLHFQ were significantly decreased in intervention group 3,6,12 months after treatment than those before treatment( P < 0.01).There were significant difference in the levels of LVEF,6MWD, BNP, cardiac functional grading and the score of MLHFQ between intervention group and control group 12 months after treatment ( P < 0.05 or P < 0.01).Conclusions CGA shows positive impact on the cardiac function and quality of life in the elderly patients with chronic heart failure.