Beich Katherine R, Yancy Clyde
RD/Baylor Transplant Institute, 3500 Gaston Avenue Dallas, TX 75246, USA.
Nutr Clin Pract. 2008 Oct-Nov;23(5):477-86. doi: 10.1177/0884533608323429.
Optimal care of patients with heart failure requires a multifaceted approach that includes guideline-driven, evidence-based therapies, intensive patient education, careful initial and follow-up assessment, and appropriately constructed nutrition prescriptions. Central to the construct of the nutrition prescription is advice regarding sodium consumption. It is intuitively and generally agreed upon that sodium restriction is appropriate for patients with heart failure, despite the lack of evidence-based research studies. Whereas limiting sodium is most appropriate for the hypertensive patient at risk for developing heart failure and the patient who is overtly volume overloaded, less certainty exists regarding the sodium prescription for patients with diagnosed heart failure that is well compensated. Sodium intake is only 1 component of medical nutrition therapy, and prescription must be individualized according to nutrition assessment and priority of needs. However, in the absence of new compelling data, sodium restriction remains the most appropriate dietary intervention in general for patients with heart failure.
心力衰竭患者的最佳护理需要多方面的方法，包括遵循指南、基于证据的治疗、强化患者教育、仔细的初始评估和随访评估，以及合理制定营养处方。营养处方的核心是关于钠摄入的建议。尽管缺乏循证研究，但直觉上人们普遍认为限制钠摄入适用于心力衰竭患者。虽然限制钠摄入最适合有发生心力衰竭风险的高血压患者以及明显容量超负荷的患者，但对于病情得到良好控制的已确诊心力衰竭患者的钠处方，仍存在较少的确定性。钠摄入只是医学营养治疗的一个组成部分，必须根据营养评估和需求优先级进行个体化处方。然而，在没有新的有力数据的情况下，一般而言，限制钠摄入仍然是心力衰竭患者最合适的饮食干预措施。
