中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2009年
10期
870-874
,共5页
华倚虹%吴娜琼%鲁向锋%谢高强%张健%顾东风%杨跃进
華倚虹%吳娜瓊%魯嚮鋒%謝高彊%張健%顧東風%楊躍進
화의홍%오나경%로향봉%사고강%장건%고동풍%양약진
心力衰竭%充血性%体重%预后
心力衰竭%充血性%體重%預後
심력쇠갈%충혈성%체중%예후
Heart failure%congestive%Body weight%Prognosis
目的 在没有心血管疾病的正常人群中,超重和肥胖会增加死亡风险.然而,某些慢性疾病患者,低体质指数(BMI)与病死率增加相关.研究旨在探讨BMI对收缩性心力衰竭(心衰)患者预后的影响.方法 对540例经超声心动图证实左室射血分数≤45%的陈旧性心肌梗死和扩张型心肌病患者进行随访,平均年龄58.53岁,其中男性84.2%.结果 在随访期间(中位随访时间24个月),共有92例死亡,其中87例患者心原性死亡,92例因心衰再次入院.与BMI≥28.0 kg/m~2肥胖的收缩性心衰患者比较,低体重(BMI<18.5 kg/m~2)和正常体重(BMI≥18.5 kg/m~2、<24.0 ks/mm~2)收缩性心衰患者全因病死率、心原性病死率、心衰病死率和总心脏事件率均显著升高(均为P<0.05),OR(95%CI)分别是5.44(1.78～16.66)、4.30(1.71～10.82),5.42(1.77～16.59)、4.00(1.59～10.10),8.94(2.37～33.74)、4.97(1.52～16.20),2.10(1.09～4.07)、1.79(1.14～2.82).多元Cox回归校正年龄、性别、NYHA分级、左室射血分数值以后,BMI分组对收缩性心衰患者全因病死率(OR=0.77,P<0.05)、心原性病死率(OR=0.78,P<0.05)和心衰病死率(OR=0.79,P<0.05)仍有显著影响.结论 收缩性心衰患者BMI低是预后差的一个独立预测因素.在南陈旧性心肌梗死和扩张型心肌病所致的收缩性心衰患者中,与肥胖患者相比,极低体重和正常体重患者全因病死率、心原性病死率和心衰病死率较高.
目的 在沒有心血管疾病的正常人群中,超重和肥胖會增加死亡風險.然而,某些慢性疾病患者,低體質指數(BMI)與病死率增加相關.研究旨在探討BMI對收縮性心力衰竭(心衰)患者預後的影響.方法 對540例經超聲心動圖證實左室射血分數≤45%的陳舊性心肌梗死和擴張型心肌病患者進行隨訪,平均年齡58.53歲,其中男性84.2%.結果 在隨訪期間(中位隨訪時間24箇月),共有92例死亡,其中87例患者心原性死亡,92例因心衰再次入院.與BMI≥28.0 kg/m~2肥胖的收縮性心衰患者比較,低體重(BMI<18.5 kg/m~2)和正常體重(BMI≥18.5 kg/m~2、<24.0 ks/mm~2)收縮性心衰患者全因病死率、心原性病死率、心衰病死率和總心髒事件率均顯著升高(均為P<0.05),OR(95%CI)分彆是5.44(1.78～16.66)、4.30(1.71～10.82),5.42(1.77～16.59)、4.00(1.59～10.10),8.94(2.37～33.74)、4.97(1.52～16.20),2.10(1.09～4.07)、1.79(1.14～2.82).多元Cox迴歸校正年齡、性彆、NYHA分級、左室射血分數值以後,BMI分組對收縮性心衰患者全因病死率(OR=0.77,P<0.05)、心原性病死率(OR=0.78,P<0.05)和心衰病死率(OR=0.79,P<0.05)仍有顯著影響.結論 收縮性心衰患者BMI低是預後差的一箇獨立預測因素.在南陳舊性心肌梗死和擴張型心肌病所緻的收縮性心衰患者中,與肥胖患者相比,極低體重和正常體重患者全因病死率、心原性病死率和心衰病死率較高.
목적 재몰유심혈관질병적정상인군중,초중화비반회증가사망풍험.연이,모사만성질병환자,저체질지수(BMI)여병사솔증가상관.연구지재탐토BMI대수축성심력쇠갈(심쇠)환자예후적영향.방법 대540례경초성심동도증실좌실사혈분수≤45%적진구성심기경사화확장형심기병환자진행수방,평균년령58.53세,기중남성84.2%.결과 재수방기간(중위수방시간24개월),공유92례사망,기중87례환자심원성사망,92례인심쇠재차입원.여BMI≥28.0 kg/m~2비반적수축성심쇠환자비교,저체중(BMI<18.5 kg/m~2)화정상체중(BMI≥18.5 kg/m~2、<24.0 ks/mm~2)수축성심쇠환자전인병사솔、심원성병사솔、심쇠병사솔화총심장사건솔균현저승고(균위P<0.05),OR(95%CI)분별시5.44(1.78～16.66)、4.30(1.71～10.82),5.42(1.77～16.59)、4.00(1.59～10.10),8.94(2.37～33.74)、4.97(1.52～16.20),2.10(1.09～4.07)、1.79(1.14～2.82).다원Cox회귀교정년령、성별、NYHA분급、좌실사혈분수치이후,BMI분조대수축성심쇠환자전인병사솔(OR=0.77,P<0.05)、심원성병사솔(OR=0.78,P<0.05)화심쇠병사솔(OR=0.79,P<0.05)잉유현저영향.결론 수축성심쇠환자BMI저시예후차적일개독립예측인소.재남진구성심기경사화확장형심기병소치적수축성심쇠환자중,여비반환자상비,겁저체중화정상체중환자전인병사솔、심원성병사솔화심쇠병사솔교고.
Objective In individuals without cardiovascular disease, elevated body mass index (BMI) is associated with an increased risk of death. However, in patients with certain chronic diseases, including heart failure, low BMI has been associated with increased mortality. We investigated the association between BMI and prognosis in patients with systolic HF. Method Follow-up was made on 540 patients (mean age 58.53 years, 84.2% men) with systolic HF (LVEF≤45%) and association between BMI and adverse cardiac events was analyzed. Results During a median follow-up of 24 months, 92 patients died including 87 cases of cardiac death and 92 patients were rehospitalized. Compared with patients with BMI higher than 28.0 kg/m~2, patients in lower BMI categories ( BMI≤18.5 kg/m~2 and≥18.5 kg/m~2 <24.0 kg/m~2) had a graded increase in the all cause death rate [5.44(1.78-16.66),4.30(1.71-10. 82) ], cardiac death rate [OR(95% CI) : 5.42(1.77-16.59) ,4.00(1.59-10.10)], HF death rate [8.94(2.37-33.74),4.97(1.52-16.20)] and MACE rate [2.10 (1.09-4.07),1.79 (1.14-2.82)]. After adjustment for age, gender, LVEF and NYHA grade using cox regression analysis, BMI categories still significantly associated with all cause death rate (OR=0.77, P<0.05), cardiac death rate (OR=0.78, P<0.05 ) and HF death rate (OR=0.79, P<0.05). Conclusion In patients with systolic heart failure, lower BMI was an independent predictor of increased all cause death rate, cardiac death rate and HF death rate.
