ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (9): 1036-1043.doi: 10.3761/j.issn.2096-7446.2026.09.002

• 论著 • 上一篇    下一篇

慢性心力衰竭急性失代偿期患者症状群及其预警症状的识别研究

赵飞(), 陈洁莹, 毛越, 姚梅琪, 金静芬*()   

  1. 浙江大学医学院附属第二医院护理部 杭州市 310009
  • 收稿日期:2025-09-19 出版日期:2026-09-10 发布日期:2026-08-31
  • 通讯作者: *金静芬，E-mail：zrjzkhl@zju.edu.cn
  • 作者简介:赵飞：女，本科（硕士在读），主管护师，护士长，E-mail：sylvia1988@zju.edu.cn
    作者贡献声明

    赵飞：研究设计、资料收集、统计分析、论文撰写；陈洁莹、毛越：资料收集、专业技术指导；姚梅琪：统计分析指导、论文修改；金静芬：研究设计、研究指导

A study on the identification of symptom clusters and warning symptoms in patients with acute decompensated chronic heart failure

ZHAO Fei(), CHEN Jieying, MAO Yue, YAO Meiqi, JIN Jingfen*()   

  1. Nursing Department， the Second Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 310009， China
  • Received:2025-09-19 Online:2026-09-10 Published:2026-08-31
  • Contact: * JIN Jingfen，E-mail：zrjzkhl@zju.edu.cn

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摘要：

目的 识别慢性心力衰竭急性失代偿期患者的症状群及预警症状，分析预警症状的严重程度与心功能和血生化指标的相关性。方法 便利选取2023年9月—2024年9月杭州市某三级甲等医院心内科住院的268例慢性心力衰竭急性失代偿期患者，采用一般资料调查表、心衰记忆症状评估量表进行问卷调查，收集患者入院后心功能和血生化相关指标。采用主成分分析法提取症状群，Apriori算法判定症状群的预警症状，分析预警症状与心功能和血生化指标的相关性。结果 慢性心力衰竭急性失代偿期患者存在4个症状群，包括体液潴留症状群、呼吸疲乏症状群、情绪心理症状群和消化代谢症状群；每个症状群内的预警症状为腿或胳膊水肿、平躺时呼吸困难、哀伤感和口干。血清B型利钠肽与腿或胳膊水肿的严重程度呈正相关（r=0.223，P=0.033），血清B型利钠肽与平躺时呼吸困难的严重程度呈正相关（r=0.201，P=0.020），心功能分级与哀伤感（r=0.360，P=0.001）、口干（r=0.238，P=0.004）的严重程度呈正相关，血钾与平躺时呼吸困难的严重程度负相关（r=-0.249，P=0.004），左室射血分数与腿或胳膊水肿呈负相关（r=-0.171，P=0.018）。结论 慢性心力衰竭急性失代偿期患者4个症状群均存在预警症状，其严重程度与心功能分级、左室射血分数、血钾及血清B型利钠肽密切相关，可为临床护理人员早期识别病情变化、制订个性化症状管理方案提供精准依据。

关键词: 心力衰竭, 急性失代偿期, 症状群, 预警症状, 护理

Abstract:

Objective To identify the symptom clusters and warning symptoms in patients with acute decompensated heart failure（ADHF），and to analyze the correlation between the severity of warning symptoms and cardiac function and blood biochemical indexes. Methods From September 2023 to September 2024，268 ADHF patients hospitalized in the cardiology wards of a tertiary Grade A hospital in Hangzhou were selected by convenience sampling. The general information questionnaire and the revised Memory Symptom Assessment Scale were used to conduct a questionnaire survey，and the related indexes of cardiac function and blood biochemistry of patients were collected after admission. The symptom clusters were extracted by principal component analysis，and the warning symptoms of the symptom cluster were determined based on the results of the Apriori algorithm. Correlation analysis was used to explore the relationship between warning symptoms and cardiac function and blood biochemistry. Results There were four symptom clusters in ADHF patients，including the fluid retention symptom cluster，the respiratory fatigue symptom cluster，the emotional and psychological symptom cluster，and the digestive and metabolic symptom cluster. Each symptom cluster corresponds to a specific warning symptom：leg or arm edema，dyspnea when lying flat，a sense of sadness，and dry mouth. The serum type B natriuretic peptide（BNP） level was positively correlated with the severity of leg or arm edema（r=0.223，P=0.033）. The serum BNP level was positively correlated with the severity of dyspnea when lying flat（r=0.201，P=0.020）. The cardiac function classification was positively correlated with the severity of sadness（r=0.360，P=0.001） and dry mouth（r=0.238，P=0.004）. Serum potassium was negatively correlated with the severity of dyspnea when lying flat（r=-0.249，P=0.004），and left ventricular ejection fraction（LVEF） was negatively correlated with leg or arm edema（r=-0.171，P=0.018）. Conclusion Warning symptoms exist in four symptom clusters among ADHF patients. The severity of warning symptoms is related to cardiac function classification，LVEF，serum potassium and serum BNP. It serves as a precise foundation for clinical nursing personnel to detect early changes in patients’ clinical status and develop individualized symptom management strategies.

Key words: Heart Failure, Acute Decompensation, Symptom Cluster, Warning Symptom, Nursing