Masterson Creber Ruth, Topaz Maxim, Lennie Terry A, Lee Christopher S, Puzantian Houry, Riegel Barbara
School of Nursing, University of Pennsylvania USA
School of Nursing, University of Pennsylvania USA.
Eur J Cardiovasc Nurs. 2014 Dec;13(6):549-58. doi: 10.1177/1474515113517606. Epub 2013 Dec 23.
A low-sodium diet is a core component of heart failure self-care but patients have difficulty following the diet.
The aim of this study was to identify predictors of higher than recommended sodium excretion among patients with heart failure.
The World Health Organization Five Dimensions of Adherence model was used to guide analysis of existing data collected from a prospective, longitudinal study of 280 community-dwelling adults with previously or currently symptomatic heart failure. Sodium excretion was measured objectively using 24-hour urine sodium measured at three time points over six months. A mixed effect logistic model identified predictors of higher than recommended sodium excretion.
The adjusted odds of higher sodium excretion were 2.90, (95% confidence interval (CI): 1.15-4.25, p<0.001) for patients who were obese; 2.80 (95% CI: 1.33-5.89, p=0.007) for patients with diabetes; and 2.22 (95% CI: 1.09-4.53, p=0.028) for patients who were cognitively intact.
Three factors were associated with excess sodium excretion and two factors, obesity and diabetes, are modifiable by changing dietary food patterns.
低钠饮食是心力衰竭自我护理的核心组成部分，但患者在遵循该饮食方面存在困难。
本研究的目的是确定心力衰竭患者中钠排泄高于推荐水平的预测因素。
采用世界卫生组织依从性模型的五个维度来指导对现有数据的分析，这些数据来自一项对280名有既往或当前有症状的社区居住成年心力衰竭患者的前瞻性纵向研究。通过在六个月内三个时间点测量的24小时尿钠来客观测量钠排泄。采用混合效应逻辑模型确定钠排泄高于推荐水平的预测因素。
肥胖患者钠排泄增加的校正比值比为2.90（95%置信区间（CI）：1.15 - 4.25，p<0.001）；糖尿病患者为2.80（95%CI：1.33 - 5.89，p = 0.007）；认知功能正常的患者为2.22（95%CI：1.09 - 4.53，p = 0.028）。
三个因素与钠排泄过多有关，其中肥胖和糖尿病这两个因素可通过改变饮食模式来改善。
