Department of Cardiology, Hebei Provincial People's Hospital, 348 Heping West Road, Hebei, 050051, Shijiazhuang, China.
Department of Nephrology, Jinzhou People's Hospital, Jinzhou City, 052260, China.
BMC Cardiovasc Disord. 2023 Feb 10;23(1):80. doi: 10.1186/s12872-023-03072-7.
The home treatment of elderly patients with chronic heart failure (CHF) is often accompanied by malnutrition, which increases the risk of re-hospitalisation and affects the prognosis. Therefore, how to effectively improve the nutritional self-management of patients is a current focus of medical research. This study aims to test the effect of home-based nutritional intervention method on improving the nutritional status of elderly patients with CHF.
A total of 90 hospitalised elderly patients with CHF were randomly divided into the experimental group (n = 45) and the control group (n = 45). The patients in both groups were given standardised drug therapy and their nutritional status was evaluated using a body composition analyser prior to discharge (protein, body fat percentage, visceral fat area, skeletal muscle, upper arm muscle circumference, left lower limb and right lower limb muscle mass), with the cardiopulmonary function evaluated using a six-minute walk test and the metabolic equivalents method. The control group was given general nutrition education and routine dietary guidance from cardiac rehabilitation nurses, while the experimental group was given an individualised nutrition prescription by dietitians based on the evaluation results, according to which one-to-one food exchange dietary intervention training was given until the patients mastered the process.
The nutritional indexes at the end of the study were significantly higher in the experimental group than in the control group and were higher than those before the intervention (P < 0.05). The muscle circumference of the upper arm, the muscle mass of the left lower limb and the right lower limb had no statistical significance following the intervention compared to the control group and before the intervention (P > 0.05). The cardiopulmonary function indexes were significantly better in the experimental group at the end of the study than before the intervention and were better than those in the control group, with statistically significant differences (P < 0.05), while no significant changes were observed in the control group before and after the intervention (P > 0.05).
The home-based nutritional intervention method of food exchange portions can effectively improve the nutritional status of elderly patients with CHF, with the distribution of visceral fat more reasonable and the cardiopulmonary function and exercise endurance improved.
老年慢性心力衰竭（CHF）患者的家庭治疗常伴有营养不良，这增加了再住院的风险，影响预后。因此，如何有效提高患者的营养自我管理能力是当前医学研究的重点。本研究旨在检验基于家庭的营养干预方法对改善老年 CHF 患者营养状况的效果。
共纳入 90 例住院老年 CHF 患者，随机分为实验组（n=45）和对照组（n=45）。两组患者均接受标准化药物治疗，并在出院前使用身体成分分析仪评估其营养状况（蛋白质、体脂百分比、内脏脂肪面积、骨骼肌、上臂肌肉周长、左下肢和右下肢肌肉量），采用 6 分钟步行试验和代谢当量法评估心肺功能。对照组由心脏康复护士给予一般营养教育和常规饮食指导，实验组由营养师根据评估结果制定个体化营养处方，根据该处方进行一对一的食物交换饮食干预训练，直至患者掌握该过程。
研究结束时，实验组的营养指标明显高于对照组，且高于干预前（P<0.05）。干预后与对照组及干预前相比，上臂肌肉周长、左下肢和右下肢肌肉量无统计学意义（P>0.05）。研究结束时，实验组心肺功能指标明显优于干预前，且优于对照组，差异有统计学意义（P<0.05），对照组干预前后无明显变化（P>0.05）。
食物交换份的家庭营养干预方法可有效改善老年 CHF 患者的营养状况，使内脏脂肪分布更合理，心肺功能和运动耐力提高。
