慢性心力衰竭患者再次住院的心血管危险因素分析  

The Risk Factors for Re-hospitalization of Chronic Heart Failure's Patients

作　　者：马俊杰[1] 庞璐[1] 刘勇[2] 

机构地区：[1]四川省遂宁市中心医院全科医学科,遂宁629000 [2]四川省遂宁市中心医院重症医学科,遂宁629000

出　　处：《微循环学杂志》2016年第1期38-41,共4页Chinese Journal of Microcirculation

摘　　要：目的:分析慢性心力衰竭(CHF)患者再次住院的心血管危险因素。方法:收集2013-01-2013-10有住院史的CHF门诊患者201例进行1年期随访,将在此期间需要住院患者作为再住院组,另选同期与CHF无关住院患者作为对照组,先行对比两组人口学资料及血流动力学指标,再行多因素logistic回归分析,预测患者再住院的心血管危险因素。结果:1年期成功随访201例CHF患者,其中再次住院者39例,占19.40%。再次住院者年龄、平均动脉压、心功能Ⅱ-Ⅲ级、心脏射血分数(EF)、N末端脑钠肽前体(NT-proBNP)和房性期前收缩与对照组差异有统计学意义(P<0.01);logistic回归分析显示EF、NT-proBNP和房性期前收缩(APB)可能是预测CHF患者再次住院的危险因素,其受试者工作特征曲线(ROC)下面积分别为0.81、0.78、0.78。结论:随访因CHF住院患者心血管危险因素有利于及时住院干预和治疗,改善患者预后。Objective：To explore the risk factors for re-hospitalization of chronic heart failure（CHF）patients.Method：Outpatients with CHF hospitalization history who visited suining central hospital from January 2013 to October 2013 were included and followed up for one year.They were divided into two groups：those who required re-hospitalization during the follow-up period as re-hospitalization group and the remaining patients as control group.Demographic characteristics and hemodynamic indexes between two groups were compared.And multivariate logistic regression analysis was used to explore the risk factors of re-hospitalization of CHF.Results：Totally 201 patients were included and 39（19.4%）patients required re-hospitalization.Significant differences between the two groups were found in age,mean arterial pressure,heart function classification,left ventricular ejection fraction,N-terminal pro brain natriuretic peptide（NT-proBNP）and premature atrial contraction.Multivariate logistic regression analysis revealed that left ventricular ejection fraction,NT-proBNP and premature atrial contraction were risk factors for re-hospitalization of CHF patients.The area under of receiver operating characteristic curve of three indictors was 0.81,0.78 and 0.78 for prediction of CHF respectively.Conclusion：Left ventricular ejection fraction,NT-proBNP and premature atrial contraction are risk factors for re-hospitalization of CHF patients according to our research.Clinicians should pay more attention to high-risk factors so as to ensure these patients receiving treatment in time and improve the prognosis.

关 键 词：慢性心力衰竭 再住院 危险因素 

分 类 号：R541.6[医药卫生—心血管疾病]