Chinese General Practice ›› 2023, Vol. 26 ›› Issue (03): 335-342.DOI: 10.12114/j.issn.1007-9572.2022.0276
Special Issue: 心力衰竭最新文章合集; 心血管最新文章合集; 营养最新文章合集; 老年问题最新文章合集
• Original Research • Previous Articles Next Articles
Received:
2022-05-11
Revised:
2022-07-21
Published:
2023-01-20
Online:
2022-09-01
Contact:
CHEN Ying
About author:
通讯作者:
陈莹
作者简介:
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URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0276
项目 | 无营养不良风险组(n=42) | 低营养不良风险组(n=181) | 中高营养不良风险组(n=156) | 检验统计量值 | P值 | |
---|---|---|---|---|---|---|
年龄〔M(P25,P75),岁〕 | 83.0(77.6,89.3) | 86.0(81.0,90.0)d | 89.0(85.0,92.0)de | 24.004c | <0.001 | |
年龄分布 | ||||||
60~80〔n(%),岁〕 | 17.0(40.5) | 44(24.3)d | 18(11.5)de | 19.316a | <0.001 | |
81~100〔n(%),岁〕 | 25.0(59.5) | 137(75.7)d | 138(88.5)de | |||
性别(男/女) | 19/23 | 123/58d | 124/32de | 19.372a | <0.001 | |
BMI( | 25.54±3.07 | 24.37±3.79d | 23.11±4.02de | 6.799b | 0.001 | |
卧床〔n(%)〕 | 4.0(9.5) | 16.0(8.8) | 49.0(31.4)de | 31.054a | <0.001 | |
住院时间〔M(P25,P75),d〕 | 10.0(7.0,12.0) | 11.0(8.0,14.0)d | 14.0(10.3,19.0)de | 38.843c | <0.001 | |
NYHA分级〔n(%)〕 | 37.051a | <0.001 | ||||
Ⅱ级 | 32.0(76.2) | 113.0(62.4)d | 54.0(34.6)de | — | — | |
Ⅲ级 | 90.0(21.4) | 54.0(29.8)d | 80.0(51.3)de | — | — | |
Ⅳ级 | 1.0(2.4) | 14.0(7.7)d | 22.0(14.1)de | — | — | |
合并疾病〔n(%)〕 | ||||||
高血压 | 37.0(88.1) | 154.0(85.1) | 134.0(85.9) | 0.258a | 0.879 | |
糖尿病 | 25.0(59.5) | 114.0(63.0) | 97.0(62.2) | 0.175a | 0.916 | |
心房颤动 | 12.0(28.6) | 61.0(33.7) | 64.0(41.0) | 3.122a | 0.210 | |
慢性肾脏病 | 5.0(11.9) | 63.0(34.8)d | 68.0(43.6)d | 14.614a | 0.001 | |
陈旧性心肌梗死 | 9.0(21.4) | 38.0(21.0) | 50.0(32.1)de | 5.809a | 0.055 | |
慢性阻塞性肺疾病 | 10.0(23.8) | 39.0(21.5) | 43.0(27.6) | 1.656a | 0.437 | |
肿瘤 | 1.0(2.4) | 28.0(15.5)d | 31.0(19.9)d | 7.631a | 0.022 | |
药物应用〔n(%)〕 | ||||||
他汀类药物 | 31.0(73.8) | 133.0(73.5) | 99.0(63.5) | 4.394a | 0.111 | |
生化指标 | ||||||
血红蛋白〔M(P25,P75),g/L〕 | 132.0(122.8,140.3) | 124.0(111.0,133.0)d | 109.0(97.0,127.0)de | 49.562c | <0.001 | |
淋巴细胞〔M(P25,P75),×109/L〕 | 1.98(1.66,2.24) | 1.43(1.11,1.80)d | 1.23(0.94,1.49)de | 58.625c | <0.001 | |
血钾( | 4.03±0.29 | 4.05±0.39 | 4.09±0.44 | 0.599b | 0.550 | |
血钠〔M(P25,P75),mmol/L〕 | 140.00(138.00,141.07) | 140.00(138.00,142.00) | 139.00(136.32,141.00)e | 6.204c | 0.045 | |
空腹血糖〔M(P25,P75),mmol/L〕 | 5.44(4.85,7.02) | 5.72(4.88,6.80) | 5.42(4.69,6.67) | 2.904c | 0.234 | |
尿素氮〔M(P25,P75),mmol/L〕 | 5.45(4.35,7.13) | 6.60(5.20,8.45)d | 7.20(5.30,9.75)de | 15.658c | <0.001 | |
肌酐〔M(P25,P75),μmol/L〕 | 76.25(65.80,90.85) | 85.90(70.95,180.00)d | 93.85(72.85,127.13)de | 13.514c | 0.001 | |
总蛋白( | 68.12±5.11 | 63.34±6.97d | 60.17±7.14de | 24.346b | <0.001 | |
血清白蛋白( | 38.70±2.66 | 36.83±3.28d | 31.39±3.24de | 155.901b | <0.001 | |
三酰甘油〔M(P25,P75),mmol/L〕 | 1.46(1.10,2.01) | 1.09(0.82,1.40)d | 0.75(0.59,0.75)de | 60.147c | <0.001 | |
总胆固醇〔M(P25,P75),mmol/L〕 | 4.74(3.97,5.36) | 3.58(3.12,4.43)d | 3.21(2.69,3.66)de | 82.847c | <0.001 | |
低密度脂蛋白胆固醇〔M(P25,P75),mmol/L〕 | 2.94(2.34,3.51) | 1.94(1.54,2.48)d | 1.67(1.34,2.03)de | 74.269c | <0.001 | |
高密度脂蛋白胆固醇〔M(P25,P75),mmol/L〕 | 1.05(0.95,1.49) | 1.06(0..87,1.34) | 1.05(0.76,1.23) | 5.274c | 0.072 | |
糖化血红蛋白〔M(P25,P75),%〕 | 6.40(5.90,7.90) | 6.30(5.85,7.25) | 6.10(5.70,7.00) | 4.158c | 0.125 | |
BNP〔M(P25,P75),mmol/L〕 | 132.00(60.00,227.00) | 157.00(75.00,295.00)d | 311.50(130.25,580.50)de | 38.160c | <0.001 | |
左心室射血分数〔M(P25,P75),%〕 | 61.00(58.00,65.00) | 62.00(57.50,64.00) | 60.00(55.00,65.00) | 4.528c | 0.104 | |
GNRI( | 106.19±6.55 | 101.06±9.26d | 89.48±10.66de | 65.538b | <0.001 | |
PNI( | 48.78±3.83 | 44.43±3.89d | 37.80±4.14de | 179.977b | <0.001 | |
1年内因HF再入院〔n(%)〕 | 9.00(21.4) | 32.00(17.7) | 56.00(35.9)de | 15.033a | 0.001 | |
1年内HF全因死亡〔n(%)〕 | 0 | 14.00(7.7)d | 62.00(39.7)de | 65.394a | <0.001 |
Table 1 Demographic and clinical indicators among older patients with HFpEF and coronary heart diseases according to the CONUT score
项目 | 无营养不良风险组(n=42) | 低营养不良风险组(n=181) | 中高营养不良风险组(n=156) | 检验统计量值 | P值 | |
---|---|---|---|---|---|---|
年龄〔M(P25,P75),岁〕 | 83.0(77.6,89.3) | 86.0(81.0,90.0)d | 89.0(85.0,92.0)de | 24.004c | <0.001 | |
年龄分布 | ||||||
60~80〔n(%),岁〕 | 17.0(40.5) | 44(24.3)d | 18(11.5)de | 19.316a | <0.001 | |
81~100〔n(%),岁〕 | 25.0(59.5) | 137(75.7)d | 138(88.5)de | |||
性别(男/女) | 19/23 | 123/58d | 124/32de | 19.372a | <0.001 | |
BMI( | 25.54±3.07 | 24.37±3.79d | 23.11±4.02de | 6.799b | 0.001 | |
卧床〔n(%)〕 | 4.0(9.5) | 16.0(8.8) | 49.0(31.4)de | 31.054a | <0.001 | |
住院时间〔M(P25,P75),d〕 | 10.0(7.0,12.0) | 11.0(8.0,14.0)d | 14.0(10.3,19.0)de | 38.843c | <0.001 | |
NYHA分级〔n(%)〕 | 37.051a | <0.001 | ||||
Ⅱ级 | 32.0(76.2) | 113.0(62.4)d | 54.0(34.6)de | — | — | |
Ⅲ级 | 90.0(21.4) | 54.0(29.8)d | 80.0(51.3)de | — | — | |
Ⅳ级 | 1.0(2.4) | 14.0(7.7)d | 22.0(14.1)de | — | — | |
合并疾病〔n(%)〕 | ||||||
高血压 | 37.0(88.1) | 154.0(85.1) | 134.0(85.9) | 0.258a | 0.879 | |
糖尿病 | 25.0(59.5) | 114.0(63.0) | 97.0(62.2) | 0.175a | 0.916 | |
心房颤动 | 12.0(28.6) | 61.0(33.7) | 64.0(41.0) | 3.122a | 0.210 | |
慢性肾脏病 | 5.0(11.9) | 63.0(34.8)d | 68.0(43.6)d | 14.614a | 0.001 | |
陈旧性心肌梗死 | 9.0(21.4) | 38.0(21.0) | 50.0(32.1)de | 5.809a | 0.055 | |
慢性阻塞性肺疾病 | 10.0(23.8) | 39.0(21.5) | 43.0(27.6) | 1.656a | 0.437 | |
肿瘤 | 1.0(2.4) | 28.0(15.5)d | 31.0(19.9)d | 7.631a | 0.022 | |
药物应用〔n(%)〕 | ||||||
他汀类药物 | 31.0(73.8) | 133.0(73.5) | 99.0(63.5) | 4.394a | 0.111 | |
生化指标 | ||||||
血红蛋白〔M(P25,P75),g/L〕 | 132.0(122.8,140.3) | 124.0(111.0,133.0)d | 109.0(97.0,127.0)de | 49.562c | <0.001 | |
淋巴细胞〔M(P25,P75),×109/L〕 | 1.98(1.66,2.24) | 1.43(1.11,1.80)d | 1.23(0.94,1.49)de | 58.625c | <0.001 | |
血钾( | 4.03±0.29 | 4.05±0.39 | 4.09±0.44 | 0.599b | 0.550 | |
血钠〔M(P25,P75),mmol/L〕 | 140.00(138.00,141.07) | 140.00(138.00,142.00) | 139.00(136.32,141.00)e | 6.204c | 0.045 | |
空腹血糖〔M(P25,P75),mmol/L〕 | 5.44(4.85,7.02) | 5.72(4.88,6.80) | 5.42(4.69,6.67) | 2.904c | 0.234 | |
尿素氮〔M(P25,P75),mmol/L〕 | 5.45(4.35,7.13) | 6.60(5.20,8.45)d | 7.20(5.30,9.75)de | 15.658c | <0.001 | |
肌酐〔M(P25,P75),μmol/L〕 | 76.25(65.80,90.85) | 85.90(70.95,180.00)d | 93.85(72.85,127.13)de | 13.514c | 0.001 | |
总蛋白( | 68.12±5.11 | 63.34±6.97d | 60.17±7.14de | 24.346b | <0.001 | |
血清白蛋白( | 38.70±2.66 | 36.83±3.28d | 31.39±3.24de | 155.901b | <0.001 | |
三酰甘油〔M(P25,P75),mmol/L〕 | 1.46(1.10,2.01) | 1.09(0.82,1.40)d | 0.75(0.59,0.75)de | 60.147c | <0.001 | |
总胆固醇〔M(P25,P75),mmol/L〕 | 4.74(3.97,5.36) | 3.58(3.12,4.43)d | 3.21(2.69,3.66)de | 82.847c | <0.001 | |
低密度脂蛋白胆固醇〔M(P25,P75),mmol/L〕 | 2.94(2.34,3.51) | 1.94(1.54,2.48)d | 1.67(1.34,2.03)de | 74.269c | <0.001 | |
高密度脂蛋白胆固醇〔M(P25,P75),mmol/L〕 | 1.05(0.95,1.49) | 1.06(0..87,1.34) | 1.05(0.76,1.23) | 5.274c | 0.072 | |
糖化血红蛋白〔M(P25,P75),%〕 | 6.40(5.90,7.90) | 6.30(5.85,7.25) | 6.10(5.70,7.00) | 4.158c | 0.125 | |
BNP〔M(P25,P75),mmol/L〕 | 132.00(60.00,227.00) | 157.00(75.00,295.00)d | 311.50(130.25,580.50)de | 38.160c | <0.001 | |
左心室射血分数〔M(P25,P75),%〕 | 61.00(58.00,65.00) | 62.00(57.50,64.00) | 60.00(55.00,65.00) | 4.528c | 0.104 | |
GNRI( | 106.19±6.55 | 101.06±9.26d | 89.48±10.66de | 65.538b | <0.001 | |
PNI( | 48.78±3.83 | 44.43±3.89d | 37.80±4.14de | 179.977b | <0.001 | |
1年内因HF再入院〔n(%)〕 | 9.00(21.4) | 32.00(17.7) | 56.00(35.9)de | 15.033a | 0.001 | |
1年内HF全因死亡〔n(%)〕 | 0 | 14.00(7.7)d | 62.00(39.7)de | 65.394a | <0.001 |
变量 | 单因素分析 | 多因素分析 | |||||
---|---|---|---|---|---|---|---|
OR(95%CI) | β | P值 | OR(95%CI) | β | P值 | ||
年龄 | 1.035(1.001,1.069) | 0.034 | 0.042 | — | — | — | |
卧床 | 0.532(0.305,0.930) | -0.630 | 0.027 | — | — | — | |
住院时间 | 1.029(1.001,1.056) | 0.028 | 0.038 | — | — | — | |
NYHA | — | — | — | ||||
Ⅱ级 | 1 | — | — | — | |||
Ⅲ级 | 2.021(1.213,3.339) | 0.699 | 0.007 | — | — | — | |
Ⅳ级 | 3.849(1.835,8.070) | 1.348 | <0.001 | — | — | — | |
合并慢性肾脏病 | 0.618(0.386,0.990) | -0.481 | 0.045 | — | — | — | |
血红蛋白 | 0.979(0.966,0.992) | -0.021 | 0.001 | — | — | — | |
尿素氮 | 1.079(1.025,1.137) | 0.076 | 0.004 | — | — | — | |
肌酐 | 1.008(1.004,1.013) | 0.008 | <0.001 | 1.009(1.003,1.015) | 0.009 | 0.004 | |
血糖 | 0.884(0.772,1.013) | -0.123 | 0.076 | — | — | — | |
血清白蛋白 | 0.899(0.849,0.951) | -0.107 | <0.001 | — | — | — | |
三酰甘油 | 0.649(0.428,0.985) | -0.432 | 0.042 | — | — | — | |
糖化血红蛋白 | 0.866(0.702,1.068) | -0.144 | 0.179 | — | — | — | |
BNP | 1.001(1.000,1.001) | 0.001 | 0.006 | 1.001(1.000,1.002) | 0.001 | 0.018 | |
左心室射血分数 | 0.933(0.888,0.930) | -0.069 | 0.006 | — | — | — | |
GNRI | 0.972(0.949,0.995) | -0.029 | 0.016 | — | — | — | |
CONUT评分 | 1.236(1.121,1.363) | 0.212 | <0.001 | — | — | — | |
PNI | 0.927(0.887,0.969) | -0.076 | 0.001 | — | — | — |
Table 2 Univariable and multivariable analyses of factors predicting HF-related readmission in elderly patients with HFpEF and coronary heart disease within 1 year after discharge
变量 | 单因素分析 | 多因素分析 | |||||
---|---|---|---|---|---|---|---|
OR(95%CI) | β | P值 | OR(95%CI) | β | P值 | ||
年龄 | 1.035(1.001,1.069) | 0.034 | 0.042 | — | — | — | |
卧床 | 0.532(0.305,0.930) | -0.630 | 0.027 | — | — | — | |
住院时间 | 1.029(1.001,1.056) | 0.028 | 0.038 | — | — | — | |
NYHA | — | — | — | ||||
Ⅱ级 | 1 | — | — | — | |||
Ⅲ级 | 2.021(1.213,3.339) | 0.699 | 0.007 | — | — | — | |
Ⅳ级 | 3.849(1.835,8.070) | 1.348 | <0.001 | — | — | — | |
合并慢性肾脏病 | 0.618(0.386,0.990) | -0.481 | 0.045 | — | — | — | |
血红蛋白 | 0.979(0.966,0.992) | -0.021 | 0.001 | — | — | — | |
尿素氮 | 1.079(1.025,1.137) | 0.076 | 0.004 | — | — | — | |
肌酐 | 1.008(1.004,1.013) | 0.008 | <0.001 | 1.009(1.003,1.015) | 0.009 | 0.004 | |
血糖 | 0.884(0.772,1.013) | -0.123 | 0.076 | — | — | — | |
血清白蛋白 | 0.899(0.849,0.951) | -0.107 | <0.001 | — | — | — | |
三酰甘油 | 0.649(0.428,0.985) | -0.432 | 0.042 | — | — | — | |
糖化血红蛋白 | 0.866(0.702,1.068) | -0.144 | 0.179 | — | — | — | |
BNP | 1.001(1.000,1.001) | 0.001 | 0.006 | 1.001(1.000,1.002) | 0.001 | 0.018 | |
左心室射血分数 | 0.933(0.888,0.930) | -0.069 | 0.006 | — | — | — | |
GNRI | 0.972(0.949,0.995) | -0.029 | 0.016 | — | — | — | |
CONUT评分 | 1.236(1.121,1.363) | 0.212 | <0.001 | — | — | — | |
PNI | 0.927(0.887,0.969) | -0.076 | 0.001 | — | — | — |
变量 | 单因素分析 | 多因素分析 | |||||
---|---|---|---|---|---|---|---|
OR(95%CI) | β | P值 | OR(95%CI) | β | P值 | ||
年龄 | 1.061(1.020,1.103) | 0.059 | 0.003 | — | — | — | |
BMI | 0.911(0.839,0.990) | -0.093 | 0.027 | — | — | — | |
卧床 | 0.246(0.139,0.436) | -1.4 | <0.001 | — | — | — | |
住院时间 | 1.109(1.064,1.115) | 0.103 | <0.001 | — | — | — | |
NYHA | — | — | — | ||||
Ⅱ级 | 1 | — | — | — | |||
Ⅲ级 | 2.769(1.564,4.904) | 1.019 | <0.001 | — | — | — | |
Ⅳ级 | 5.217(2.375,11.463) | 1.652 | <0.001 | — | — | — | |
血红蛋白 | 0.966(0.952,0.980) | -0.035 | <0.001 | — | — | — | |
淋巴细胞 | 0.495(0.299,0.821) | -0.703 | 0.006 | — | — | — | |
血钠 | 0.934(0.872,1.002) | -0.068 | 0.055 | — | — | — | |
总蛋白 | 0.956(0.922,0.992) | -0.044 | 0.017 | — | — | — | |
血清白蛋白 | 0.805(0.750,0.864) | -0.217 | <0.001 | — | — | — | |
三酰甘油 | 0.663(0.420,1.048) | -0.411 | 0.079 | — | — | — | |
BNP | 1.001(1.001,1.002) | 0.001 | <0.001 | 1.001(1.000,1.002) | 0.002 | 0.012 | |
左心室射血分数 | 0.928(0.880,0.979) | -0.075 | 0.007 | — | — | — | |
GNRI | 0.939(0.912,0.967) | -0.063 | <0.001 | — | — | — | |
CONUT评分 | 1.644(1.392,1.943) | 0.497 | <0.001 | 1.567(1.302,1.885) | 0.449 | <0.001 | |
PNI | 0.084(0.796,0.890) | -0.173 | <0.001 | — | — | — |
Table 3 Univariable and multivariable analyses of factors predicting all-cause mortality in elderly patients with HFpEF and coronary heart diseases within 1 year after discharge
变量 | 单因素分析 | 多因素分析 | |||||
---|---|---|---|---|---|---|---|
OR(95%CI) | β | P值 | OR(95%CI) | β | P值 | ||
年龄 | 1.061(1.020,1.103) | 0.059 | 0.003 | — | — | — | |
BMI | 0.911(0.839,0.990) | -0.093 | 0.027 | — | — | — | |
卧床 | 0.246(0.139,0.436) | -1.4 | <0.001 | — | — | — | |
住院时间 | 1.109(1.064,1.115) | 0.103 | <0.001 | — | — | — | |
NYHA | — | — | — | ||||
Ⅱ级 | 1 | — | — | — | |||
Ⅲ级 | 2.769(1.564,4.904) | 1.019 | <0.001 | — | — | — | |
Ⅳ级 | 5.217(2.375,11.463) | 1.652 | <0.001 | — | — | — | |
血红蛋白 | 0.966(0.952,0.980) | -0.035 | <0.001 | — | — | — | |
淋巴细胞 | 0.495(0.299,0.821) | -0.703 | 0.006 | — | — | — | |
血钠 | 0.934(0.872,1.002) | -0.068 | 0.055 | — | — | — | |
总蛋白 | 0.956(0.922,0.992) | -0.044 | 0.017 | — | — | — | |
血清白蛋白 | 0.805(0.750,0.864) | -0.217 | <0.001 | — | — | — | |
三酰甘油 | 0.663(0.420,1.048) | -0.411 | 0.079 | — | — | — | |
BNP | 1.001(1.001,1.002) | 0.001 | <0.001 | 1.001(1.000,1.002) | 0.002 | 0.012 | |
左心室射血分数 | 0.928(0.880,0.979) | -0.075 | 0.007 | — | — | — | |
GNRI | 0.939(0.912,0.967) | -0.063 | <0.001 | — | — | — | |
CONUT评分 | 1.644(1.392,1.943) | 0.497 | <0.001 | 1.567(1.302,1.885) | 0.449 | <0.001 | |
PNI | 0.084(0.796,0.890) | -0.173 | <0.001 | — | — | — |
Figure 1 ROC curve analysis of the CONUT score,GNRI and PNI in predicting readmission for HF in elderly patients with HFpEF and coronary heart diseases within 1 year after discharge
Figure 2 ROC curve analysis of the CONUT score,GNRI and PNI in predicting all-cause mortality in elderly patients with HFpEF and coronary heart diseases within 1 year after discharge
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