老年充血性心力衰竭患者稀释性低钠血症与心功能等级的关系分析  

Correlation analysis between dilutional hyponatremia and cardiac function grades in the elderly

作　　者：方放[1] 黄方[1] 张瑗[1] 钱晓明[1] 

机构地区：[1]中国人民解放军南京军区南京总医院干部病房中国人民解放军南京军区老年病研究中心,江苏省南京市210002

出　　处：《实用老年医学》2013年第6期474-476,共3页Practical Geriatrics

摘　　要：目的分析老年慢性充血性心力衰竭(CHF)患者水、电解质紊乱与心功能之间的关系。方法总结分析我院老年病科2010年6月至2012年6月住院的183例因各种原因引起的CHF患者的临床资料,同时选取60例健康体检者作为对照组,分析心功能与血钠、钾、镁、钙含量及尿量的关系。结果 CHF组患者心功能下降,其中NYHA心功能Ⅱ级57例,心功能Ⅲ级77例,心功能Ⅳ级49例;患者血清电解质紊乱以低钠为主,血钠浓度与正常组比较下降,差异有统计学意义(P<0.05);NYHA心功能Ⅱ、Ⅲ、Ⅳ级患者血清钠浓度依次降低,差异具有统计学意义(P<0.05)。CHF组血清钾、镁、钙浓度与对照组比较无统计学差异(P>0.05)。结论积极改善老年CHF患者水、电解质代谢可能有助于改善患者心功能,治疗CHF时应积极纠正水、电解质紊乱。Objective To analyze the correlation of serum fluid and electrolyte imbalance with cardiac function grades in elderly patients with congestive heart failure(CHF). Methods 183 cases of CHF from June 2010 to June 2012 in the Department of Geriatrics were analyzed, and 60 healthy controls were enrolled. Correlation of cardiac function grades with serum sodium, serum potassium, serum magnesium, serum calcium and urinary volume were analyzed. Results Cardiac function decline was observed in the patients with CHF,and there were 57 cases of grade Ⅱ, 77 of grade Ⅲ and 49 of grade Ⅳ. Hyponatremia was the most common serum electrolyte imbalance in the patients, and serum sodium was signi-ficantly declined in CHF group compared with the control group(P<0.05). Serum sodium decreased gradually significantly in NYHA cardiac function gradeⅡ, Ⅲ, Ⅳ (P<0.05). However, there were no significant differences in serum potassium, serum magnesium, serum calcium between the two groups(P>0.05). Conclusions Actively improving balance of water and electrolyte metabolism in the elderly with CHF may contribute to improving cardiac function. Fluid and electrolyte imbalance should be quickly corrected in CHF treatment.

关 键 词：稀释性低钠血症 水电解质紊乱 心功能 老年人 

分 类 号：R541.6[医药卫生—心血管疾病]