PG-SGA在老年慢性心力衰竭营养评估中的应用初探

摘要

To investigate the application of PG-SGA in nutritional assessment of elderly patients with chronic heart failure.Methods A continuous approach was used to screen a total of 125 elderly patients who were hospitalized in the Beijing Shijitan Hospital Capital Medical University and Rizhao Central Hospital from October 2017 to February 2019.According to the NYHA classification of heart failure the patients were divided into the clinical heart failure group grade Ⅱ～Ⅳ and the pre-clinical heart failure group grade I .Patients were evaluated for nutritional status using PG-SGA.The body mass index BMI albumin ALB pre-albumin PA hemoglobin Hb and NT-proBNP were measured.The correlation between each test index and PG-SGA was observed.The relationship between PG-SGA score and cardiac function classification was studied.Results The incidence of malnutrition in the clinical heart failure group was significantly higher than that in the pre-clinical heart failure group P<0.001 .Compared to the patients rated unmalnutrition the patients rated malnutrition got lower BMI ALB PA Hb levels and a higher NT-proBNP level P<0.05 .PG-SGA scores and PA levels have statistically significant differences between each cardiac function classification subgroups P<0.05 .Conclusions The incidence of malnutrition in elderly chronic heart failure patients is high and PG-SGA could be used for the nutritional assessment of these patients.PG-SGA scores might be used as an auxiliary index to evaluate cardiac function.%目的 应用PG-SGA评估老年慢性心力衰竭患者的营养状况,分析营养状况与心功能相关性.方法 采用连续入组方法,选取2017年10月至2019年2月在首都医科大学附属北京世纪坛医院、日照市中心医院住院治疗的老年慢性心力衰竭患者125例,根据NYHA心功能分级分为前临床心衰组(I级)和临床心衰组(Ⅱ～Ⅳ级).采用PG-SGA行营养评估,同时对体质指数、血清白蛋白、前白蛋白、血红蛋白及N端前脑钠肽检测,观察PG-SGA指标与上述指标的相关性.结果 临床心衰组营养不良发生率高于前临床心衰组(P<0.001).相对于PG-SGA评级营养正常患者,营养不良患者体质指数、血清白蛋白、前白蛋白及血红蛋白降低,N端前脑钠肽升高(P<0.05). PG-SGA评分、前白蛋白水平在心功能Ⅰ～Ⅳ级各亚组间比较差异均具有统计学意义(P<0.05).结论 老年慢性心力衰竭患者营养不良发生率高,PG-SGA可作为该类患者的营养评估的工具;PG-SGA评分可在一定程度上作为辅助评估心力衰竭严重程度的潜在指标.