發(fā)布時間：2018-02-26 22:40

  本文關(guān)鍵詞： 慢性心力衰竭 老年 肌肉含量 去脂肪體重指數(shù)　出處：《吉林大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：研究目的:老年慢性心力衰竭(Chronic heart failure,CHF)患者會發(fā)生肌肉含量的下降,去脂肪體重指數(shù)(Fat-free mass index,FFMI)是近年來在臨床上評價肌肉含量的重要指標。利用生物電阻抗分析法(Bioelectrical impedance analysis,BIA)所測得的FFMI等指標對老年CHF患者的肌肉含量進行評價,并對CHF患者FFMI、BMI等與其血清生化指標、左心室射血分數(shù)(Left ventricular ejection fraction,LVEF)、左心室舒張末徑(Left ventricular end-diastolic diameter,LVEDD)等是否存在相關(guān)性進行討論。方法:本研究收集了自2015年11月初至2016年2月末因CHF就診于吉林大學(xué)白求恩第一臨床醫(yī)院的共計71名患者作為實驗組(平均年齡71.77±0.89歲,男性34人),對照組33人(平均年齡69.48±1.15歲,男性14人),兩組在年齡、性別等無統(tǒng)計學(xué)差異(年齡71.77±0.89歲vs.69.48±1.15歲,P=0.135;男性34(49%)vs.14(42%),P=0.514),所有納入研究者接受常規(guī)化驗檢查、超聲心動圖檢查以及BIA檢測。全部數(shù)據(jù)分析應(yīng)用Graph Pad Prism5、SPSS 19.0軟件統(tǒng)計分析。結(jié)果:與對照組相比,CHF組患者FFMI更低,其差異有統(tǒng)計學(xué)意義(16.29±2.13kg/3s.18.39±2.03 kg/m2,P0.001);利用CHF組患者FFMI進行相關(guān)性分析后得出,FFMI與骨骼肌質(zhì)量(Skeletal muscle mass,SMM)(r=0.851,P0.001)及體重指數(shù)(Body mass index,BMI)(r=0.688,P0.001)存在正相關(guān);FFMI與年齡呈負相關(guān)(r=-0.373,P=0.001);與LVEF呈正相關(guān)(r=0.252,P=0.034)。將CHF組根據(jù)FFMI值分為低FFMI組、中FFMI組及高FFMI組,BMI在三組間有顯著差異(P0.001);年齡在三組間差異有統(tǒng)計學(xué)意義(P=0.009);NT-pro BNP在三組間差異有統(tǒng)計學(xué)意義(P=0.031)。根據(jù)BMI分為三組,分別為消瘦及正常組(BMI24.0 kg/m2),超重組(24.0 kg/m2≤BMI28.0 kg/m2)及肥胖組(BMI≥28 kg/m2),除甘油三酯及膽固醇外,其他資料在三組間無統(tǒng)計學(xué)差異。結(jié)論:1.老年CHF患者,與同年齡段對照組相比,其肌肉含量有較為明顯的下降。2.CHF患者,年齡越大,其肌肉含量的下降越明顯。3.CHF患者,FFMI與評價心衰嚴重程度的指標具有一定的相關(guān)性,可作為評價CHF的指標。
[Abstract]:Objective: in elderly patients with chronic heart failure, chronic heart failure (CHF) may result in a decrease in muscle content. Fat-free mass index (FFMI) is an important index for the clinical evaluation of muscle content in recent years. The muscle content of elderly patients with CHF was evaluated by bioelectrical impedance analysis (bioelectrical impedance analysis), such as FFMI. The serum biochemical indexes and FFMI index in patients with CHF were also analyzed. The correlation between left ventricular ejection fractionation and left ventricular end-diastolic dimension left ventricular end-diastolic diameterus was discussed. Methods: from the beginning of 2015 to the end of February 2016, Bai Qiuen, Jilin University, was treated with CHF for the first time. A total of 71 patients (mean age 71.77 鹵0.89 years) in clinical hospital were treated as experimental group. There was no significant difference in age and sex between the two groups (age 71.77 鹵0.89 years, vs.69.48 鹵1.15 years old, vs.69.48 0.135 years old, male 34 949 鹵vs.140.21 yr, P 0.514 14), and all the participants were examined by routine laboratory examination, while the control group was 33 cases (mean age 69.48 鹵1.15 years old, male 14 years old), and there was no significant difference between the two groups in age and sex (age 71.77 鹵0.89 years, vs.69.48 鹵1.15 years old, P < 0.135). All data were analyzed by Graph Pad Prism5SPSS 19.0 software. Results: compared with the control group, the FFMI of the patients with BIA was significantly lower than that of the control group (16.29 鹵2.13 kg / 3? S. 18.39 鹵2.03 kg 路m ~ (2) P _ (0.001); using FFMI of patients with CHF, we found that there was a positive correlation between FFMI and skeletal muscle mass and body mass index (0.688P0.001), a positive correlation between FFMI and age, and a positive correlation with LVEF (r = 0.252) and (0.034). The CHF group was divided into low FFMI group according to FFMI value. There were significant differences in FFMI of middle FFMI group and high FFMI group among the three groups (P 0.001), and there was significant difference in age between the three groups. There was significant difference in NT-pro BNP among the three groups (P = 0.031). According to BMI, the patients were divided into three groups. BMI24.0 kg / m2, hyperrecombination of 24.0 kg/m2 鈮，

本文編號：1539985