心力衰竭患者出院后转归及影响因素分析  

The outcomes of patients with heart failure after discharge and its related factors

作　　者：常宇飞[1] 马剡芳[1] 刘京鹤[1] 陈永福[1] 

机构地区：[1]首都医科大学附属北京地坛医院,北京100015

出　　处：《中国预防医学杂志》2016年第11期842-845,共4页Chinese Preventive Medicine

摘　　要：目的分析心力衰竭患者出院后预后状况及影响因素,为早期临床干预提供依据。方法采用前瞻性病例对照研究方法,统计2013年6月至2015年6月,首都医科大学附属北京地坛医院348例冠心病心力衰竭患者终点事件发生率（出院后1年内死亡或再住院）,并据此分为预后不良与预后良好组。采用SPSS 17.0软件,计量资料采用独立样本t检验,计数资料采用χ~2检验,多因素分析采用非条件logistic回归分析,P〈0.05为差异有统计学意义。结果 348例患者出院后1年内因心力衰竭再住院率为16.95%（59/348）,死亡率为12.07%（42/348）,因心力衰竭再住院率或死亡率为29.02%（101/348）。多因素分析显示性别（95%CI：0.145-0.875,P=0.025）、年龄（95%CI：0.587-1.301,P=0.030）、体质量指数（95%CI：0.458-1.253,P=0.004）、血Na＋（95%CI：0.812-1.245,P=0.041）、血红蛋白浓度（Hb）（95%CI：0.925-1.027,P=0.032）、LgNT-ProBNP（95%CI：1.201-7.258,P=0.025）均为影响心力衰竭患者出院后1年内预后的独立危险因素。结论心力衰竭患者出院后1年内死亡或再住院仍然较高,年龄、性别、贫血等是主要影响因素。Objective To discuss the outcome of patients with heart failure after discharge and its influencing factors,and to provide the evidence for early clinical intervention. Methods A prospective case-control study was conducted in which the incidence of end events（death or readmission within one year after discharge）was analyzed among 348 patients at Beijing Ditan Hospital affiliated to Capital Medical University between June 2013 to June 2015.Patients were divided into poor prognosis group and good prognosis group.Chi-square test,t test and multivariate logistic regression analysis were used for data statistical analysis. Results The readmission rate of patients due to heart failure was 16.95%（59/348）within one year after discharge,and the mortality rate was 12.07%（42/348）,accounting for 29.02% of total readmission rate and death rate in 348 patients.Multivariate logistic regression analysis showed that gender（95%CI：0.458-1.253,P=0.004）,age（95% CI：0.587-1.301,P=0.030）,body mass index（95% CI：0.458-1.253,P=0.004）,blood Na＋（95%CI：0.812-1.245,P=0.041）,Hb（95%CI：0.925-1.027,P=0.032）,LgNT-ProBNP（95%CI：1.201-7.258,P=0.025）were the independent risk factors of the prognosis of patients with heart failure within 1year after discharge. Conclusions The death rate and readmission rate of patients with heart failure within 1 year after discharge are still high,and age,gender,anemia and others are major influencing factors.

关 键 词：心力衰竭 再住院 死亡 影响因素 

分 类 号：R541.6[医药卫生—心血管疾病]