关键词: 心力衰竭, 人体成分分析, 利尿, 水分

Abstract: Background　Heart failure is an unavoidable syndrome in the end stage of heart disease.It has a high mortality and disability rate. Water and sodium retention is the main manifestation of heart failure. Human component analyzer can accurately evaluate the intracellular and extracellular water content of human body. At present, there are few reports about the application of human component analysis in guiding clinical medication in the treatment of heart failure at home and abroad. Objective　To analyze the body fluid distribution and nutritional status of patients with heart failure before and after diuretic treatment. Methods　A total of 33 patients with heart failure（heart failure group） admitted to the Department 4 of Cardiology, Hebei General Hospital and 33 patients without heart failure（non-heart failure group） admitted in the same hospital from January 2017 to January 2018 were selected as the study subjects. White blood cell count（WBC）, hemoglobin（Hb） , albumin（ALB） , aspartate aminotransferase（AST） , alanine aminotransferase（ALT） , creatinine（Cr） , blood potassium, blood sodium, total cholesterol（TC） , total triglyceride（TG） , high density lipoprotein（HDL）, low density lipoprotein（LDL） were measured. Nutrition physicians in our hospital measured extracellular water（ECW） , intracellular water（ICW） , total body water（TBW） , intracellular water/total body water（ICW%） , total body water/body mass （TBW%） , protein content, skeletal muscle content, body fat rate, extracellular water/total body water（ECW%） before and after diuretic treatment in heart failure group and non-heart failure group．The differences between the above indexes before and after diuretic treatment in heart failure group and non-heart failure group were compared. Results　There were no significant differences in sex and age between the two groups（χ2=0.243, P=0.622; t=1.405, P=0.165）．There were significant differences in Hb, ALB and Cr between the two groups（P<0.05） ．ICW% before diuretic treatment in heart failure group was lower than that in non-heart failure group, and ECW%（whole body, right upper extremity, left upper extremity, right lower extremity, left lower extremity） was higher than that in non-heart failure group（P<0.05）．After diuretic treatment, ECW%（whole body, right upper extremity, left upper extremity, trunk, right lower extremity, left lower extremity） in heart failure group was higher than that in non-heart failure group（P<0.05） ．ICW% increased and ECW%（whole body） decreased after diuretic treatment in heart failure group（P<0.05）．Conclusion　The abnormal water distribution and fluid retention in extracellular fluid in patients with heart failure showed that ECW（whole body, right upper extremity, left upper extremity, right lower extremity, left lower extremity） increased, while ICW% decreased, especially in lower extremity edema.Diuretic treatment could correct the above abnormalities to a certain extent. ECW%（whole body） decreased and ICW%（whole body） increased in patients with heart failure after diuretic treatment, but ECW%（right upper extremity, left upper extremity, trunk, right lower extremity, left lower extremity） had no difference before and after the treatment in heart failure group.

Key words: Heart failure, Human body composition analysis, Diuresis, Water