【摘要】 目的 探讨超声心动图参数及老年营养风险指数（geriatric nutritional risk index,GNRI）联合预测老年慢性心力衰竭（chronic heart failure,CHF）患者预后的价值。方法 回顾性选取2023年2月至2024年7月宜春市人民医院功能科收治的102例老年CHF患者，根据随访6个月的结果将患者分为预后良好组67例与预后不良组35例，比较两组患者临床资料，包括左心室射血分数（left ventricular ejection fraction,LVEF）、左心室舒张末期内径（left ventricular end-diastolic diameter,LVEDD）、左心室收缩末期内径（left ventricular end-systolic diameter,LVESD）以及GNRI，采用logistic回归分析老年CHF患者预后的影响因素，并通过ROC曲线分析超声心动图参数及GNRI对患者预后的预测效能。结果 预后不良组年龄、LVEDD、LVESD明显高于预后良好组，CHF病程明显长于预后良好组，LVEF、GNRI明显低于预后良好组，差异有统计学意义（P<0.01）。多因素logistic回归分析显示，LVEF、LVEDD、LVESD、GNRI是老年CHF患者预后的影响因素（P<0.05,P<0.01）。LVEF、LVEDD、LVESD、GNRI及其联合检测评估老年CHF患者预后不良的曲线下面积分别为0.854、0.773、0.785、0.850、0.902，联合检测对老年CHF患者预后不良的评估效能优于各指标单独检测（P<0.05）。结论 超声心动图参数及GNRI与老年CHF患者预后有关，其联合检测对老年CHF患者预后不良的评估效能较好。更多还原

【Abstract】 Objective To investigate the value of combination of echocardiographic(ECG) parameters and geriatric nutritional risk index(GNRI) in predicting the prognosis of elderly chronic heart failure(CHF). Methods A retrospective study was conducted on 102 elderly CHF patients admitted to our hospital from February 2023 to July 2024. According to their clinical outcomes after 6 months of follow-up, they were divided into a good prognosis group(67 cases) and a poor prognosis group(35 cases). The clinical data, such as left ventricular ejection fraction(LVEF), left ventricular end-diastolic inner diameter(LVEDD) and left ventricular end-systolic inner diameter(LVESD), and GNRI were compared between two groups. Logistic regression analysis was adopted to identify the influencing factors of prognosis of elderly CHF patients, and ROC curve was plotted to analyze the predictive efficiency of ECG parameters and GNRI for the prognosis. Results The poor prognosis group exhibited significantly advanced age, higher LVEDD and LVESD, longer course of CHF, and lower LVEF and GNRI in comparison with the good prognosis group(P<0.01). Multivariate logistic regression analysis indicated that LVEF, LVEDD, LVESD and GNRI were identified as influencing factors for elderly CHF prognosis(P<0.05, P<0.01). In evaluating the poor prognosis, LVEF, LVEDD, LVESD, GNRI and their combination presented an AUC value of 0.854, 0.773, 0.785, 0.850 and 0.902, respectively. The evaluation efficiency of combined detection was superior to that of single detection in assessing the poor prognosis in elderly CHF patients(P<0.01). Conclusion ECG parameters and GNRI are related to the prognosis in elderly CHF patients, and combined detection has good evaluation efficiency for the poor prognosis.更多还原