心力衰竭患者症状群研究的系统综述

doi:10.3761/j.issn.1672-9234.2025.11.018

摘要/Abstract

摘要：

目的对心力衰竭患者症状群的研究进行系统综述。方法检索Embase、PubMed、CINAHL、Cochrane Library、Web of Science、中国知网、中国生物医学文献数据库、维普、万方数据库中有关心力衰竭患者症状群的研究。检索时限为建库至2024年11月7日。由2名研究者独立进行文献筛选和资料提取，并根据美国卫生保健研究和质量机构推荐的横断面研究质量评价标准、纽卡斯尔-渥太华量表对文献方法学质量进行评价后，总结症状群种类及内部构成、评估工具、分析方法与影响因素。结果共纳入28篇文献，提取出48种症状群，心力衰竭患者最常见的5种症状群依次为淤血症状群、情绪症状群、缺血症状群、疲倦症状群及呼吸困难症状群；评估工具共16种，其中Memoria心力衰竭症状评估量表使用最多；分析方法共4种，其中聚类分析法应用最广泛；影响因素包括人口学、疾病相关、心理与社会支持及其他因素。结论心力衰竭患者症状群多样，且受多种因素影响。未来，需进一步制订心力衰竭患者症状归属及症状群命名标准，开发本土化的心力衰竭患者症状群评估工具，优化症状群的识别方法，丰富影响因素的探索视角。

关键词: 心力衰竭, 症状群, 评估工具, 影响因素, 系统综述

Abstract:

Objective To conduct a systematic review on the symptom clusters of patients with heart failure. Methods Databases including Embase，PubMed，CINAHL，Cochrane Library，Web of Science，CNKI，CBM，VIP，and Wanfang were searched for studies on symptom clusters in patients with heart failure from the establishment of databases to November 7，2024. Two researchers independently performed literature screening and data extraction. After evaluating the methodological quality of the literature—using the cross-sectional study quality assessment criteria recommended by the Agency for Healthcare Research and Quality（AHRQ） for cross-sectional studies and the Newcastle-Ottawa Scale（NOS） for cohort studies，the types and characteristics of symptom clusters，assessment tools，analytical methods，and influencing factors were analyzed. Results A total of 28 literatures were included，and 48 symptom clusters were extracted. The five most common symptom clusters in patients with heart failure were congestion symptom cluster，emotional symptom cluster，ischemic symptom cluster，fatigue symptom cluster and dyspnea symptom cluster in sequence. There were 16 evaluation tools，among which Memorial Symptom Assessment Scale for Heart Failure（MSAS-HF） was used the most. There were four analytical methods，among which cluster analysis was the most widely used. The influencing factors classified into three categories：demographic factors；disease-related factors；psychological and social support，and other factors. Conclusion Patients with heart failure have diverse symptom clusters，which are affected by multiple factors. In the future，it is necessary to further develop standards for symptom attribution and symptom cluster naming in patients with heart failure，develop localized assessment tools for symptom clusters in these patients and optimize the identification methods of symptom clusters，and expand the research perspectives on influencing factors.

Key words: Heart Failure, Symptom Clusters, Assessment Tools, Influencing Factors, Systematic Review

胡安倩, 张春, 蔡闵敏, 张洁琼, 王璐. 心力衰竭患者症状群研究的系统综述[J]. 中华护理教育, 2025, 22(11): 1397-1403.

HU Anqian, ZHANG Chun, CAI Minmin, ZHANG Jieqiong, WANG Lu. A systematic review of symptom clusters in patients with heart failure[J]. Chinese Journal of Nursing Education, 2025, 22(11): 1397-1403.

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