住院冠心病心力衰竭患者的预后相关因素分析  

Analysis of factor related prognosis in hospitalized patients with coronary heart failure and heart failure

作　　者：陈鑫[1] 解玉水[1] 殷兆芳[1] 卞玲[1] 陈启稚[1] 黄海怡[1] 王长谦[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院心内科,上海市200011

出　　处：《心血管康复医学杂志》2016年第3期247-250,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨住院冠心病心衰患者的临床及冠脉病变特征,以判断预后。方法:回顾性分析我院2009年12月至2011年12月行冠脉造影的住院心衰患者91例的临床资料。根据截止2014年12月底的生存情况,患者被分为死亡组(41例)和存活组(50例),对比其临床特点和冠脉病变特征。根据冠脉造影结果,又将各组患者进一步分为冠脉造影单支病变、双支病变及三支病变组,比较各类患者的预后差异。结果:与存活组比较,死亡组既往心梗比例(31.25%比53.49%)、合并症数量[(2.57±1.28)个比(3.70±1.34)个]、贫血比例(31.25%比55.81%)、血肌酐[(97.98±40.93)μmol/L比(132.21±60.66)μmol/L]和N末端脑钠肽原(NT-proBNP)[(1731.21±1758.85)pg/ml比(3196.36±1977.13)pg/ml]水平显著升高,P<0.05或<0.01。与存活组比较,死亡组三支病变比例(56.0%比70.7%)显著升高,P=0.018。结论:冠心病心衰患者既往心梗史、合并症、贫血比例,血肌酐、NT-proBNP水平与预后有关,死亡组的冠脉三支病变患者的比例显著高于存活组。Objective:To explore clinical and coronary lesion characteristics of hospitalized patients with coronary heart disease(CHD)and heart failure(HF)for judging prognosis.Methods:Clinical data of 91 hospitalized HF patients,who underwent coronary angiography(CAG)in our hospital from Dec 2009 to Dec 2011,were retrospectively analyzed.According to survival condition till the end of Dec 2014,patients were divided into death group(n=41)and survival group(n=50),clinical characteristics and coronary lesion features were compared between two groups.According to CAG results,each group was further divided into,single vessel coronary disease(single vessel),double-vessel coronary disease(double vessel)and triple-vessel coronary disease(triple vessel)group,prognosis difference was compared among different subgroups.Results:Compared with survival group,there were significant rise in percentages of myocardial infarction history(31.25% vs.53.49%)and anemia(31.25% vs.55.81%),number of complications[(2.57±1.28)vs.(3.70±1.34)],levels of serum Cr[(97.98±40.93)μmol/L vs.(132.21±60.66)μmol/L]and NTproBNP[(1731.21±1758.85)pg/ml vs.(3196.36±1977.13)pg/ml]in death group,P<0.05or<0.01.Compared with survival group,percentage of triple-vessel coronary disease(56.0% vs.70.7%)significantly rose in death group,P=0.018.Conclusion:Percentages of myocardial infarction history,complications,anemia,and levels of serum Cr,NTproBNP were related with prognosis in hospitalized CHD patients with HF,the patients with triple-vessel disease in death group were significantly higher than those of survival group.

关 键 词：冠心病 心力衰竭 冠状动脉疾病 

分 类 号：R541.409[医药卫生—心血管疾病]