| Objective: To investigate the body fluid distribution and nutritional status in patients with heart failure before and after diuretic treatment.Objects and Methods:1 Objects:The experimental group: 33 patients with heart failure who were hospitalized in four wards of Hebei People’s Hospital from January 2017 to January 2018 were collected.The control group: 33 patients without heart failure were selected.2 Methods:The experimental group of patients based on their corr esponding selective application of diuretics,such as furosemide and hydr ochlorothiazide.At the same time,angiotensin converting enzyme inhibit ors(ACEI)/ angiotensin receptor blocker(ARB),beta blocker,aldostero ne receptor antagonist were applied.The application of body compositio n analyzer(INBODAY S10 from Korea)was determined before and aft er heart failure in patients with diuretic diuretic and control group of ex tracellular water(ECW),intracellular water(ICW),total body water(TB W),the body and body segments water ratio(ECW%,swelling index,extracellular water / total body water),protein content,body fat rate,sk eletal muscle content,and calculate the total moisture / body cells(IC W%),total water / body weight(TBW%).The next day after admission and collected venous blood,the blood routine detection of white blood cells(WBC),hemoglobin(Hb),the alanine aminotransferase(ALT),aspartat e aminotransferase(AST),creatinine(Cr),total cholesterol(TC),total tri glyceride(TG),low density lipoprotein(LDL),high density lipoprotein(HDL),albumin(ALB)and other indicators.The differences between the above indicators and the control group were compared before and after diuresis in patients with heart failure.2.1 Statistical method: All data were processed with SPSS 20.0statistical software.The measurement data meet normal distribution with mean + standard deviation(?x±s).If we do not satisfy normal distribution or skew distribution,we use median and four quantile distance to represent it.The measurement data test of normality and homogeneity of variance test first,if the two samples accord with normal distribution and variance,select two independent samples t test,if the two samples with normal distribution and homogeneity of variance,using two sample t test(separate varianceestimation t-test),if the two samples do not meet it the normal distribution and homogeneity of variance,using two independent samples nonparametric test.With P=0.05 as the test level,P<0.05 thought the difference was statistically significant,P < 0.01 was notable statistically significant for difference.Results:1.Before diuretic treatment the heart failure patients,body,torso,right upper limb and lower limbs ECW% were higher than the control group,the differences were statistically significant;before diuresis in patients with congestive heart failure the left upper limb ECW% higher than the control group,the difference was statistically significant.Body ECW%(40.51±2.20)vs.(37.50 + 1.05),P < 0.01;trunk ECW%(39.84 + 15.82)vs.(37.65 + 0.60),P < 0.01;right upper limb ECW%(38.31 + 0.71)vs.(37.63 + 0.62),P < 0.01;right lower limb ECW%(40.28 + 1.67)vs.(37.57 + 0.82),P < 0.01;left lower limb ECW%(40.04 + 1.85)vs.(37.91 + 0.73),P < 0.01;the left upper limb ECW%(38.47 + 0.70)vs.(37.92 + 0.57),P < 0.05.ICW% was lower than that of the control group [(58.82±2.55)vs.(62.05 + 1.20),P < 0.05],and the difference was statistically significant.There were no statistical differences in ECW,ICW,TBW,TBW%,body fat rate,skeletal muscle content and protein content between patients with heart failure before diuretic treatment,compared with those in control group(P > 0.05).2.Heart failure patients after diuretic treatment the body,torso and lower limbs ECW% were higher than the control group,the differences were statistically significant;heart failure patients after diuretic treatment upperlimbs ECW% higher than the control group,the difference was statistically significant.Body ECW%(38.27±1.70)vs.(37.50 + 1.05),P < 0.01;torso ECW%(39.67 + 1.35)vs.(37.65 + 0.60),P < 0.01;right lower limb ECW%(39.92 + 1.68)vs.(37.57 + 0.82),P < 0.01;left lower limb(39.83 + 1.5)vs.(37.91 + 0.73),P < 0.01;right upper limb ECW%(38.12 + 0.64)vs.(37.63 +0.62),P < 0.05;the left upper limb ECW%(38.25 + 0.61)vs.(37.92 + 0.57),P < 0.05.ICW% of heart failure patients after diuretic treatment was lower than that of the control group [(61.36±2.08)vs.(62.05 + 1.20),P < 0.01],and the difference was significant statistically.There were no statistical differences in ECW,ICW,TBW,TBW%,body fat rate,protein content and skeletal muscle content of patients with heart failure after diuretic treatment,compared with those in control group(P > 0.05).3.The body ECW% of patients with heart failure decreased after diuretic treatment [(40.51±2.20)vs.(38.27±1.70),P<0.01],while ICW% increased[(58.82±2.55)vs.(61.36±2.08),P<0.01],the difference was statistically significant.There were no statistical differences in ECW,ICW,TBW,TBW%,ECW%(both upper limbs,lower limbs,torso),body fat rate,skeletal muscle content and protein content of patients with heart failure before diuretic treatment,compared with those after diuretic treatment(P > 0.05).Conclusions:1.Heart failure patients with abnormal distribution of moisture,fluid retention in the extracellular fluid,as extracellular fluid ratio increased,while the proportion of cells in the body fluid decreased,segmental extracellular water ratio was higher than that of control group,especially in the lower extremity edema,diuretic therapy can correct the abnormality in a certain extent.2.After diuretic treatment in patients with heart failure,the proportion of extracellular fluid decreased,the proportion of intracellular fluid increased,compared with those without diuretic treatment,there were no statistical differences in the proportion of water in each segment of body between the two groups.3.Diuretics have no adverse effects on the nutritional status of patients with heart failure. |
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