摘要
目的:通过Meta分析探讨心力衰竭患者营养不良的危险因素.方法:计算机检索PubMed、Embase、Web of Science、Cochrane Library、CINAHL、MEDLINE、维普期刊数据库、万方数据库、中国知网以及中国生物医学文献数据库,检索时限为建库至2023年7月,采用RevMan5.4软件进行Meta分析.结果:共纳入17篇文献,纳入样本量累计5 883例,其中营养不良患者2 591例(45.3％),共包含12项危险因素,1项保护因素,Meta分析结果显示,年龄增长、无配偶、月收入＜3 000元、NYHA分级为Ⅲ级及以上、吸烟、水肿、合并慢性阻塞型肺疾病、合并糖尿病、BNP值或NT-ProBNP值增高、血红蛋白含量降低、血清总蛋白＜60 g/L为心力衰竭患者营养不良的危险因素(P＜0.05),服用ACEI/ARB为心力衰竭患者营养不良的保护因素(P＜0.05).结论:心力衰竭患者营养不良的危险因素较多,护理人员可依据上述的危险因素,识别易发生营养不良的患者,尽早进行营养支持,改善患者预后,提高其生活质量.
Abstract
Objective:To identify the risk factors of malnutrition in patients with heart failure by meta-analysis.Methods:PubMed,Embase,Web of Science,Cochrane Library,CINAHL,Medline,VIP,Wanfang,CNKI and SinoMed were searched.The search time was from the establishment of the database to July,2023.Meta-analysis was performed using RevMan 5.4.Results:A total of 17 studies were included in the analysis.The sample sizes ranged from 105 to 1 120 cases,with a total of 5 883 cases,of which 2 591 cases(45.3％)were identified as malnourished.Twelve risk factors and one protective factor were identified.The meta-analysis results revealed that increasing age,absence of a spouse,monthly income less than 3 000 yuan,NYHA grade Ⅲ or above,smoking,edema,comorbidity with COPD,comorbidity with diabetes,increased BNP or NT-ProBNP values,decreased hemoglobin level,and serum total protein less than 60g/L were all significant risk factors for malnutrition in patients with heart failure(P＜0.05).The use of ACEI/ARB was a protective factor against malnutrition in heart failure patients(P＜0.05).Conclusions:There are multiple risk factors associated with malnutrition in patients with heart failure.Nurses can utilize risk factors to identify patients at risk of malnutrition and implement effective preventive measures promptly.Providing nutritional support early on can ultimately improving the prognosis and enhancing the quality of life for patients.
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