目的 探讨多组分运动干预联合多学科指导下营养干预应用于老年慢性心力衰竭（CHF）并发衰弱患者的效果。方法 选择郑州市第七人民医院收治的CHF并衰弱患者102例, 纳入时间为2023年11月—2024年10月, 按照随机数表法分为对照组51例给予常规运动干预+多学科指导下营养干预,观察组51例给予多组分运动干预+多学科指导下营养干预,观察两组衰弱状态、心功能指标、营养状况、生活质量、不良事件发生率。结果 与对照组相比,观察组干预后身体、心理、社会及总分明显更低（P<0.05）。与对照组相比,观察组干预后左室射血分数（LVEF）水平明显更高,超敏心肌肌钙蛋白T（hs-cTnT）、N末端B型利钠肽前体（NT-proBNP）、左室舒张末期内径（LVEDD）水平更低（P<0.05）。与对照组相比, 观察组干预后主观整体营养状况评价表（PG-SGA）评分明显更低,血红蛋白（Hb）、前白蛋白（PA）、白蛋白（ALB）水平更高（P<0.05）。与对照组相比,观察组干预后症状、身体、情感及总分更低（P<0.05）。观察组不良事件发生率（1.96%）低于对照组（15.69%）（P<0.05）。结论 对CHF并发衰弱患者应用多组分运动干预联合多学科指导下营养干预,能够减轻衰弱状态, 改善心功能及营养状况,促进生活质量的提升, 并降低不良事件发生率。

       Objective To explore the effect of multi-component exercise intervention combined with nutritional intervention under multidisciplinary guidance in elderly patients with chronic heart failure（CHF）and frailty．Methods From November 2023 to October 2024, 102 CHF patients with frailty admitted to Zhengzhou Seventh People's Hospital were selected and included． According to the computer grouping method, they were divided into a control group with 51 patients, received routine exercise intervention and multidisciplinary nutrition intervention,and an observation group with 51 patients, received multi-component exercise intervention and multidisciplinary nutrition intervention．The frailty status, cardiac function indicators, nutritional status, quality of life and incidence of adverse events were observed in both groups．Results Compared with the control group,the observation group showed significantly lower physical, psychological, social, and total scores after intervention（P<0.05）．Compared with the control group, the observation group showed significantly higher levels of left ventricular ejection fraction and lower levels of high-sensitivity cardiac troponin N-terminal pro-B-type natriuretic peptide, and left ventricular end-diastolic dimension after intervention（P<0.05）．Compared with the control group,the observation group had significantly lower Patient-Generated Subjective Global Assessment scores and higher levels of hemoglobin, prealbumin, and albumin after intervention（P<0.05）．Compared with the control group, the observation group had significantly lower symptoms, physical, emotional, and total scores after intervention（P<0.05）．The incidence of adverse events in the observation group（1.96%）was lower than that in the control group（15.69%）（P<0.05）．Conclusions Multi-component exercise intervention combined with multidisciplinary nutritional intervention in patients with CHF and frailty can alleviate frailty, improve cardiac function and nutritional status,quality of life, and reduce the incidence of adverse events．

目的 探讨生脉注射液联合环磷腺苷治疗慢性心力衰竭的临床疗效及对其心功能的影响。方法 选择本院2016年3月—2017年4月收治的90例慢性心力衰竭患者,随机将其分为2组,各45例。对照组采用环磷腺苷静脉滴注治疗,在此基础上观察组加用生脉注射液治疗,比较两组临床疗效、心功能及药物不良反应。结果 2个疗程后,观察组总有效率、LVEF、CI及CO水平均较对照组高,差异有统计学意义(P＜0.05);两组治疗期间药物不良反应率相比,差异无统计学意义(P＞0.05)。结论 生脉注射液联合环磷腺苷可提高慢性心力衰竭临床疗效,改善心功能,且用药安全性较高。

目的 探究曲美他嗪对慢性心力衰竭患者血清炎症因子水平及心功能的影响。方法 选择2015年4月—2016年3月我院收治的慢性心力衰竭患者94例,根据随机数表法分为两组,每组47例。对照组实施阿托伐他汀治疗,观察组在此基础上予以曲美他嗪治疗。比较两组患者治疗6个月后血清炎症因子和脑利钠肽(BNP)、心功能以及临床疗效。结果 观察组血清C-反应蛋白(CRP)、BNP、肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异有统计学意义(P＜0.05);观察组左收缩末期内径(LVESD)、左室舒张末期内径(LVEDd)水平较对照组明显降低,而左室射血分数(LVEF)高于对照组,差异有统计学意义(P＜0.05);观察组患者治疗有效率与对照组相比明显提高,差异有统计学意义(P＜0.05)。结论 对慢性心力衰竭患者实施曲美他嗪治疗,能有效提高患者临床疗效,降低患者血清炎症因子,改善心功能,值得临床推广与应用。

Objective To investigate the effect of Trimetazidine on serum inflammatory factors levels and cardiac function in patients with chronic heart failure (CHF). Methods 94 CHF patients admitted into our hospital from April 2015 to March 2016 were divided into two groups randomly, 47 cases in each. Control group took Atorvastatin, and on this basis observation group was given Trimetazidine. The serum inflammatory factors levels, brain natriuretic peptide (BNP), cardiac function and clinical efficacy of two groups after treatment for 6 months were compared. Results The serum C-reactive protein (CRP), BNP, Tumor necrosis factor-α (TNF-α) levels of observation group were lower than control group (P<0.05); The left ventricular end-systolic diameter (LVESD), Left ventricular end-diastolic diameter (LVEDd) levels of observation group significantly decreased compared with control group, but left ventricular ejection fraction (LVEF) was higher than control group (P<0.05); The curative effective rate of observation group significantly increased compared with control group (P<0.05). Conclusion Trimetazidine for treating CHF patients may effectively increase clinical efficacy, decrease serum inflammatory factors and improve cardiac function, which is worthy of clinical promotion and application.

目的 观察真武四物汤足浴治疗阳虚血瘀型慢性心力衰竭(CHF)的临床疗效。方法 72例心功能Ⅱ-Ⅲ患者按随机数字表法分为治疗组(36例)和对照组(36例),对照组给予心衰常规治疗。治疗组在心衰常规治疗基础上加用真武四物汤足浴,每次30分钟,每日2次,共治疗4周。观察治疗后6 min步行距离改善情况。结果 治疗组心功能和中医症候总有效率分别为88.89%和94.44%,对照组总有效率分别为69.44%和66.67%,两组比较差异(P＜0.01或P＜0.05);两组治疗前后6 min步行距离比较差异(P＜0.05);两组治疗后6 min步行距离比较差异有统计学意义(P＜0.01)。结论 在常规治疗的基础上联合真武四物汤足浴,可以改善阳虚血瘀型慢性心力衰竭患者的临床症状,提高运动耐量,促进心力衰竭患者的康复。

       目的   探究血清多配体蛋白聚糖-1（SCD-1）与可溶性血管内皮生长因子受体-2（sVEGFR-2）表达水平在老年慢性心力衰竭患者预后评估的判定价值。方法   选取2023年1月—2024年3月珠海市第五人民医院检验科收治的110例老年慢性心力衰竭患者，检测其血清SCD-1和sVEGFR-2水平，对患者进行随访调查，了解其再次由于心力衰竭住院、心源性死亡的情况。运用多因素Logistic回归分析，探究老年慢性心力衰竭患者预后影响因素。结果  Logistic回归分析显示，心功能分级（OR=3.433，95%CI：0.934~6.431）、B型脑钠肽升高（OR=2.462，95%CI：0.861~4.765）、血清SCD-1升高（OR=3.795，95%CI：0.972~6.894）、血清sVEGFR-2升高（OR=3.842，95%CI：0.942~6.912）为影响老年慢性心力衰竭患者预后不良的重要因素（P＜0.05）；联合血清SCD-1和sVEGFR-2曲线下面积0.962与B型脑肽钠曲线下面积0.844，相较于单一SCD-1曲线下面积0.658、sVEGFR-2曲线下面积0.712明显偏高（P＜0.05）。结论   经研究证实，老年慢性心力衰竭患者预后效果不理想，其血清SCD-1和sVEGFR-2监测水平异常升高，和老年慢性心力衰竭预后不佳存在关联性，可视为老年慢性心力衰竭患者判定预后效果的主要标志物。

      Objective  To investigate the prognostic value of serum syndecan-1（SCD-1）and soluble vascular endothelial growth factor receptor-2（sVEGFR-2）expression levels in elderly patients with chronic heart failure．Methods  A total of 110 elderly patients with chronic heart failure admitted to our hospital were selected，with a time interval of January 2023 to March 2024．Serum SCD-1 and sVEGFR-2 levels were detected and follow-up investigations were conducted to understand their re hospitalization and cardiogenic death due to heart failure．Multiple logistic  regression analysis was used to explore the prognostic factors affecting elderly patients with chronic heart failure．Results  According to logistic retrospective analysis，heart function grading（OR=3.433，95%CI：0.934-6.431），elevated B-type brain natriuretic peptide（OR=2.462，95%CI：0.861-4.765），elevated serum SCD-1（OR=3.795，95%CI：0.972-6.894），and elevated serum sVEGFR-2（OR=3.842，95%CI：0.942-6.912）were important factors affecting the poor prognosis of elderly patients with chronic heart failure，with differences P＜0.05．The area under the curve of combined serum SCD-1 and sVEGFR-2 was 0.962，and the area under the curve of B-type brain peptide sodium was 0.844，which was significantly higher than that of a single SCD-1 curve of 0.658 and sVEGFR-2 curve of 0.712，with a difference of P＜0.05．Conclusions  Research has confirmed that the prognosis of elderly patients with chronic heart failure is not satisfied，and their serum SCD-1 and sVEGFR-2 monitoring levels are abnormally elevated，which is related to the poor prognosis of elderly patients with chronic heart failure．It can be regarded as the main biomarker for defining the prognosis of elderly patients with chronic heart failure．