摘要
目的观察急性失代偿性心力衰竭(ADHF)患者的血清钠离子和尿酸水平对短期预后的预测价值。方法回顾性分析2013年1月至2015年12月铜川矿务局中心医院心血管内科收治的200例ADHF患者的临床资料,并记录患者入院时的血清钠离子和尿酸水平,以及出院后30 d内的因心力衰竭再入院或全因死亡事件。结果出院后30 d内有84例(42. 0%)患者发生因心力衰竭再入院或全因死亡,不良事件发生组患者的左心室射血分数和血清钠离子浓度低于无不良事件组[12%±4%比20%±5%,P <0. 01;(133±3) mmol/L比(139±5) mmol/L,P <0. 01],而血清尿酸水平高于无不良事件组[(8. 4±0. 4) mg/dl比(7. 8±0. 2) mg/dl,P <0. 01]。多因素回归分析显示,左心室射血分数降低(OR=0. 864,95%CI:0. 754～0. 921,P <0. 01)、血清钠离子浓度降低(OR=0. 733,95%CI:0. 683～0. 832,P <0. 01)和血清尿酸水平升高(OR=1. 434,95%CI:1. 389～1. 986,P <0. 01)是ADHF患者出院后短期内发生不良事件的独立危险因素。结论 ADHF患者入院时血清钠离子浓度降低和血清尿酸水平升高,对出院后短期内因心力衰竭再入院或全因死亡有一定的预测价值。
Objective To observe the levels of serum sodium and uric acid and to evaluate their clinical value on short-term prognosis in patients with acute decompensated heart failure(ADHF). Methods A total of 200 patients with ADHF in Cardiology Department of Central Hospital of Tongchuan Mining Bureau were enrolled into this study from January of 2013 to December of 2015.The laboratory and clinical data were collected and HF readmission rate or all-cause death at 30-day after discharge were recorded. Results After 30-day discharge HF readmission or all-cause death were seen in 84 cases(42.0%).Patients with adverse events(AE) had lower left ventricular ejection fraction(LVEF)and serum sodium level than those without AE [12%±4% vs. 20%± 5%, P<0.01;(133±3)mmol/L vs .(139±5)mmol/L, P<0.01]. Serum uric acid level was higher than those without AE [(8.4±0.4)mg/dl vs.(7.8±0.2)mg/dl, P<0.01].Multivariate regression analysis showed that decreased LVEF( OR =0.864,95% CI :0.754-0.921, P< 0.01),lower serum sodium level ( OR = 0.733,95% CI :0.683-0.832, P<0.001)and elevated serum uric acid level( OR =1.434, 95% CI : 1.389-1.986, P<0.01)were independent risk factors for short-term AE in ADHF patients after discharge. Conclusions Decreased serum sodium level and increased uric acid level on-admission may be valuable for prediction of HF readmission or all-cause mortality in ADHF patients at 30-day after discharge.
作者
马乔娟
刘超
张军
金静
Ma Qiaojuan;Liu Chao;Zhang Jun;Jin Jing(Department of Cardiology,Central Hospital of Tongchuan Mining Bureau,Tongchuan 727000,China)
出处
《中国心血管杂志》
2018年第6期473-476,共4页
Chinese Journal of Cardiovascular Medicine
关键词
急性失代偿性心力衰竭
病人再入院
钠
尿酸
左心室射血分数
Acute decompensated heart failure
Patient readmission
Sodium
Uric acid
Left ventricular ejection fraction
