去脂肪体重指数对老年慢性心衰患者肌肉含量的评估及分析
发布时间：2018-02-26 22:40
本文关键词： 慢性心力衰竭 老年 肌肉含量 去脂肪体重指数 出处：《吉林大学》2016年硕士论文 论文类型：学位论文
【摘要】：研究目的:老年慢性心力衰竭(Chronic heart failure,CHF)患者会发生肌肉含量的下降,去脂肪体重指数(Fat-free mass index,FFMI)是近年来在临床上评价肌肉含量的重要指标。利用生物电阻抗分析法(Bioelectrical impedance analysis,BIA)所测得的FFMI等指标对老年CHF患者的肌肉含量进行评价,并对CHF患者FFMI、BMI等与其血清生化指标、左心室射血分数(Left ventricular ejection fraction,LVEF)、左心室舒张末径(Left ventricular end-diastolic diameter,LVEDD)等是否存在相关性进行讨论。方法:本研究收集了自2015年11月初至2016年2月末因CHF就诊于吉林大学白求恩第一临床医院的共计71名患者作为实验组(平均年龄71.77±0.89岁,男性34人),对照组33人(平均年龄69.48±1.15岁,男性14人),两组在年龄、性别等无统计学差异(年龄71.77±0.89岁vs.69.48±1.15岁,P=0.135;男性34(49%)vs.14(42%),P=0.514),所有纳入研究者接受常规化验检查、超声心动图检查以及BIA检测。全部数据分析应用Graph Pad Prism5、SPSS 19.0软件统计分析。结果:与对照组相比,CHF组患者FFMI更低,其差异有统计学意义(16.29±2.13kg/3s.18.39±2.03 kg/m2,P0.001);利用CHF组患者FFMI进行相关性分析后得出,FFMI与骨骼肌质量(Skeletal muscle mass,SMM)(r=0.851,P0.001)及体重指数(Body mass index,BMI)(r=0.688,P0.001)存在正相关;FFMI与年龄呈负相关(r=-0.373,P=0.001);与LVEF呈正相关(r=0.252,P=0.034)。将CHF组根据FFMI值分为低FFMI组、中FFMI组及高FFMI组,BMI在三组间有显著差异(P0.001);年龄在三组间差异有统计学意义(P=0.009);NT-pro BNP在三组间差异有统计学意义(P=0.031)。根据BMI分为三组,分别为消瘦及正常组(BMI24.0 kg/m2),超重组(24.0 kg/m2≤BMI28.0 kg/m2)及肥胖组(BMI≥28 kg/m2),除甘油三酯及胆固醇外,其他资料在三组间无统计学差异。结论:1.老年CHF患者,与同年龄段对照组相比,其肌肉含量有较为明显的下降。2.CHF患者,年龄越大,其肌肉含量的下降越明显。3.CHF患者,FFMI与评价心衰严重程度的指标具有一定的相关性,可作为评价CHF的指标。
[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 卤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 卤0.89 years, vs.69.48 卤1.15 years old, vs.69.48 0.135 years old, male 34 949 卤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 卤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 卤0.89 years, vs.69.48 卤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 卤2.13 kg / 3? S. 18.39 卤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，
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