[1]徐玲香,潘生智,陆兴沛.慢性心力衰竭急性发作患者院内死亡的危险因素分析▲[J].内科,2018,13(04):557-560.[doi:DOI:10.16121/j.cnki.cn45-1347/r.2018.04.06]
 XU Lingxiang,PAN Shengzhi,LU Xingpei.Analysis of risk factors for in-hospital death in patients with acute heart failure[J].Internal Medicine of China,2018,13(04):557-560.[doi:DOI:10.16121/j.cnki.cn45-1347/r.2018.04.06]
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慢性心力衰竭急性发作患者院内死亡的危险因素分析▲()
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《内科》[ISSN:1006-6977/CN:61-1281/TN]

卷:
13卷
期数:
2018年04
页码:
557-560
栏目:
论著
出版日期:
2018-08-13

文章信息/Info

Title:
Analysis of risk factors for in-hospital death in patients with acute heart failure
文章编号:
1673-7768(2018)04-0557-04
作者:
徐玲香1潘生智2陆兴沛2
武威职业学院附属中医医院,1 心病科,2 内科;甘肃省武威市733000
Author(s):
XU Lingxiang1 PAN Shengzhi2 LU Xingpei2
Affiliated Traditional Chinese Medicine Hospital of Wuwei Vocational College, 1 Department of Cardiology, 2 Internal Medicine; Wuwei, Gansu 733000, China
关键词:
慢性心力衰竭急性发作院内死亡危险因素多因素Logistic回归分析
Keywords:
Acute exacerbation of chronic heart failure Hospital mortality Risk factors Multivariate logistic regression analysis
分类号:
R 541
DOI:
DOI:10.16121/j.cnki.cn45-1347/r.2018.04.06
文献标志码:
A
摘要:
目的分析慢性心力衰竭急性发作(ACHF)患者院内死亡的危险因素,提高临床诊治水平。方法选取2015年2月至2017年1月我院收治的慢性心力衰竭急性发作患者408例为研究对象,收集患者的临床资料,根据患者的预后分为存活组(358例)和死亡组(50例),对影响患者院内死亡的因素进行单因素分析和多因素Logistic回归分析。结果单因素分析结果显示,死亡组患者的CHF病程、合并疾病、NYHA心功能分级、LVEF、BUN、血钠、肺部湿啰音/胸片肺淤血/肺水肿/胸腔积液、双下肢/骶部水肿、淤血性肝肿大/腹水情况与存活组患者比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,左心射血分数<45%、BUN>6.8 mmol/L、血钠>146或<135 mmol/L、肺部湿啰音/胸片肺淤血/肺水肿/胸腔积液、淤血性肝肿大/腹水为ACHF患者院内死亡的独立危险因素。结论导致ACHF患者院内死亡的因素复杂,左心射血分数、BUN、血钠水平异常等是患者院内死亡的独立危险因素;临床接诊ACHF患者应重点关注其心功能、水钠潴留及肾功能情况,对出现水钠潴留的患者必须及时采取有效措施,以减少患者院内死亡的发生。
Abstract:
ObjectiveTo analyze the risk factors of in-hospital death in patients with acute heart failure (ACHF) and to improve the level of clinical diagnosis and treatment. Methods408 patients with acute exacerbation of chronic heart failure admitted to our hospital from February 2015 to January 2017 were selected as subjects. The clinical data of the patients were collected and divided into survival group (358 cases) and death group (50 cases) according to the prognosis of the patients. Univariate analysis and multivariate logistic regression analysis were performed on the factors affecting the hospital mortality. ResultsUnivariate analysis showed that CHF course, comorbid disease, NYHA cardiac function grading, LVEF, BUN, blood sodium, pulmonary wet snoring/chest X-ray congestion/pulmonary edema/pleural effusion, lower extremity/ankle edema, congestive liver Swollen/ascites status compared with surviving patients. The differences were statistically significant (P<0.05). Multivariate logistic regression analysis showed left ejection fraction <45%, BUN>6.8 mmol/L, blood sodium>146 or <135 mmol/L, pulmonary wetness/thoracic pulmonary congestion/pulmonary edema/thoracic cavity Fluid, congestive hepatomegaly/ascites is an independent risk factor for hospital mortality in patients with ACHF. ConclusionThe factors leading to hospital death in patients with ACHF are complicated. Left heart ejection fraction, BUN, and abnormal blood sodium levels are independent risk factors for hospital death. Patients with clinical ACHC should pay attention to their heart function, water and sodium retention and renal function. Patients with sodium and water retention must take effective measures in time to reduce the occurrence of death in hospital.

相似文献/References:

[1]张焕耀,吴浩龙.急性主动脉夹层患者院内死亡的危险因素分析[J].内科,2018,13(04):672.[doi:DOI:10.16121/j.cnki.cn45-1347/r.2018.04.43]
 [J].Internal Medicine of China,2018,13(04):672.[doi:DOI:10.16121/j.cnki.cn45-1347/r.2018.04.43]

备注/Memo

备注/Memo:
▲基金项目:甘肃省武威市自选课题项目(WW120214)
更新日期/Last Update: 2018-08-14