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冠心病患者预后营养指数与纽约心脏协会心功能分级的关系:一项基于中国农村社区冠心病队列研究的中医研究

Relationship Between Prognostic Nutrition Index and New York Heart Association Classification in Patients with Coronary Heart Disease: A RCSCD-TCM Study.

作者信息

Ma Mei, Liu Yijia, Liu Fanfan, Li Zhu, Cheng Qi, Liu Zhao, Yang Rongrong, Yu Chunquan

机构信息

Department of Graduate Schools, Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China.

Department of Information Center, Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People's Republic of China.

出版信息

J Inflamm Res. 2022 Jul 28;15:4303-4314. doi: 10.2147/JIR.S371045. eCollection 2022.

Abstract

AIM

This study aimed to elucidate the relationship between the prognostic nutrition index (PNI) of patients with coronary heart disease (CHD) and the New York Heart Association (NYHA) classification and the complex relationship between PNI combined body mass index (BMI) and NYHA classification.

METHODS

The PNI was applied to 17,413 consecutive patients with CHD. Patients were divided into three groups according to PNI: normal nutrition (PNI ≥ 38), moderate malnutrition (35 < PNI < 38), and severe malnutrition (PNI ≤ 35). A total of 2,052 CHD patients with BMI were selected and stratified by combined subgroups of nutritional status and BMI. Logistic regression analysis was used to evaluate the relationship between the PNI and NYHA classification and to adjust for confounding factors.

RESULTS

The prevalence of malnutrition among the 17,413participants with CHD was 4.2%. Moderate and severe malnutrition were significantly related to NYHA class III and V, and the strongest relationship was observed in NYHA class V (odd ratio [OR]: 6.564; 95% confidence interval [CI]: 4.043-10.658). Malnourished-underweight patients and malnourished-overweight patients were significantly associated with higher NYHA classification, and malnourished-underweight patients (OR: 8.038; 95% CI: 2.091-30.892) were significantly more than malnourished-overweight patients (OR: 3.580; 95% CI: 1.286-9.966).

CONCLUSION

There were differences in the NYHA classification of CHD patients with different nutritional statuses. The lower the PNI, the worse the NYHA classification of CHD patients. Malnourished-underweight patients had a worse NYHA classification than malnourished-overweight patients.

摘要

目的

本研究旨在阐明冠心病(CHD)患者的预后营养指数(PNI)与纽约心脏协会(NYHA)分级之间的关系,以及PNI联合体重指数(BMI)与NYHA分级之间的复杂关系。

方法

对17413例连续的冠心病患者应用PNI。根据PNI将患者分为三组:营养正常(PNI≥38)、中度营养不良(35<PNI<38)和重度营养不良(PNI≤35)。共选取2052例有BMI数据的冠心病患者,并按营养状况和BMI的联合亚组进行分层。采用逻辑回归分析评估PNI与NYHA分级之间的关系,并对混杂因素进行校正。

结果

17413例冠心病参与者中营养不良的患病率为4.2%。中度和重度营养不良与NYHAⅢ级和Ⅴ级显著相关,在NYHAⅤ级中观察到最强的相关性(比值比[OR]:6.564;95%置信区间[CI]:4.043 - 10.658)。营养不良的体重过轻患者和营养不良的体重过重患者与更高的NYHA分级显著相关,且营养不良的体重过轻患者(OR:8.038;95%CI:2.091 - 30.892)显著多于营养不良的体重过重患者(OR:3.580;95%CI:1.286 - 9.966)。

结论

不同营养状况的冠心病患者在NYHA分级上存在差异。PNI越低,冠心病患者的NYHA分级越差。营养不良的体重过轻患者比营养不良的体重过重患者的NYHA分级更差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f37/9342891/d7daa19c75d2/JIR-15-4303-g0001.jpg

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