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JAHA:急性心衰患者的预后营养指数与临床结局的相关性研究

2017-06-26 MedSci MedSci原创

既往研究显示营养状况与心力衰竭患者的临床结局有关。 本次研究旨在评估预后营养指数(PNI)指标的营养状况与急性心力衰竭住院患者的生存率之间的关系。

既往研究显示营养状况与心力衰竭患者的临床结局有关。 本次研究旨在评估预后营养指数(PNI)指标的营养状况与急性心力衰竭住院患者的生存率之间的关系。

本研究共纳入了一个三级医疗中心的1673例(年龄76±13岁,男性占68%)因急性心衰住院的患者。PNI计算为10×血清白蛋白(g / dL)+ 0.005×总淋巴细胞计数(mm3)。 评估分析国家死亡登记处的数据以确定全因死亡和心血管死亡的临床结局。随着PNI的三分位数增加,年龄和N末端尿素利钠肽的降低,体重指数、肾小球滤过率和血红蛋白的增加。 在31.5个月的平均随访期间,更高的PNI三分位数与总研究人群中的全因死亡率和心血管死亡率以及左室射血分数减少的研究对象更好的生存结局相关。在考虑年龄、性别、估计的肾小球滤过率、左心室射血分数、血钠水平和入院收缩压后,PNI与心血管死亡和总死亡率呈相关性(自然对数的每1 SD的风险比 PNI分别为0.76 [95%CI,0.66-0.87]和0.79 [95%CI,0.73-0.87])。在按年龄、性别、左心室射血分数、体重指数或估计的肾小球滤过率分层的亚组分析中,PNI与死亡率一致相关。

本研究结果显示预后营养指数PNI是左室射血分数降低或不变的心衰住院患者的远期生存率的独立影响因素。

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