社会衰弱对老年稳定性慢性心力衰竭患者远期预后的影响

doi:10.3969/j.issn.1003-9198.2026.05.006

摘要/Abstract

摘要： 目的探讨社会衰弱(SF)对老年稳定性CHF患者远期预后的影响。方法以2022年1月1日至2024年6月30日期间符合纳排标准的215例稳定性CHF患者为研究对象,患者均接受规范的药物治疗和康复治疗。记录患者的一般临床资料,应用社会衰弱量表(HALFT)评估研究对象是否存在SF。对患者进行随访,随访终点事件为主要不良心血管事件(MACE),随访截止日期为2025年6月30日。采用生存曲线以及Cox回归探讨SF对MACE的影响。结果在215例患者中,有126例存在SF,SF患病率为58.6%。SF组1年和3年无MACE生存率分别为84.1%和60.5%,非SF组1年和3年无MACE生存率分别为89.9%和76.6%。Kaplan-Meier曲线分析表明,SF组和非SF组无MACE生存曲线差异有统计学意义(χ²=4.425,P=0.035)。多因素Cox回归校正合并症、NYHA心功能分级、N末端B型利钠肽原和LVEF后发现,SF是影响MACE的独立危险因素。结论老年CHF患者存在SF的比例较高,且SF是导致CHF患者不良心血管结局的独立危险因素。

关键词: 慢性心力衰竭, 老年人, 社会衰弱, 预后

Abstract: Objective To explore the impact of social frailty (SF) on long-term prognosis in the elderly patients with stable chronic heart failure(CHF). Methods A total of 215 patients with stable CHF who met the inclusion and exclusion criteria from January 1, 2022 to June 30, 2024 were selected as the research subjects. All the patients received standardized guideline-directed drug therapy and rehabilitation. The general clinical data of the patients were recorded and SF was evaluated using the Help, Participation, Loneliness, Financial, Talk (HALFT) scale. The patients were followed up, with the endpoint event being major adverse cardiovascular events (MACE), and the follow-up was terminated on June 30, 2025. Survival curves and Cox regression were used to explore the impact of SF on MACE. Results Among the 215 patients, 126 had SF, with a prevalence rate of 58.6%. The 1-year and 3-year MACE-free survival rates in the SF group were 84.1% and 60.5%, while those in the non-SF group were 89.9% and 76.6%, respectively. Kaplan-Meier curve analysis showed that there was a statistically significant difference in the MACE-free survival curves between the SF group and the non-SF group (χ²=4.425, P=0.035). After adjusting for comorbidities, NYHA heart function classification, N-terminal pro-B-type natriuretic peptide, and left ventricular ejection fraction in the multivariate Cox regression, SF was found to be an independent risk factor for MACE. Conclusions SF is common in elderly CHF patients and is an independent risk factor for adverse cardiovascular outcomes in stable CHF patients.

Key words: chronic heart failure, aged, social frailty, prognosis

中图分类号:

R 541.61

李春芳, 刘佳, 王乐, 陈佳, 潘晓婷. 社会衰弱对老年稳定性慢性心力衰竭患者远期预后的影响[J]. 实用老年医学, 2026, 40(5): 464-468.

LI Chunfang, LIU Jia, WANG Le, CHEN Jia, PAN Xiaoting. Impact of social frailty on long-term prognosis in elderly patients with stable chronic heart failure[J]. Practical Geriatrics, 2026, 40(5): 464-468.

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