低氯血症增加慢性心力衰竭患者住院时间及院内死亡率  

Hypochloremia is associated with longer hospital stay and higher in-hospital mortality in patients with chronic heat failure

作　　者：刘洪泽[1] 李广平[1] LIU Hong-ze LI Guang-ping(Department of Cardiology, The Second Hospital, Tianjin Medical University, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Tianjin 300211, China)

机构地区：[1]天津医科大学第二医院心脏科天津市心血管病离子与分子机能重点实验室天津心脏病学研究所,天津300211

出　　处：《天津医科大学学报》2017年第4期334-336,共3页Journal of Tianjin Medical University

摘　　要：目的:探讨慢性心力衰竭(CHF)患者低氯血症与住院时间及院内死亡风险的关系。方法:入选因CHF入院的患者341例,根据患者入院时的血氯浓度,分为低氯血症组(氯≤96 mmol/L)和正常组(氯>96 mmol/L),记录患者的年龄、性别、查体、用药史、既往病史、检验指标、左室射血分数、住院时间及院内死亡等,比较两组间基线水平及住院时间、院内死亡率有无差别。结果:CHF住院患者低氯血症的发生率为19.65%,低氯血症组二氧化碳结合力、尿素氮、尿素氮/肌酐、尿酸、总胆红素水平及口服袢利尿剂、螺内酯、合并糖尿病率均高于正常组(P<0.05),收缩压、血钠浓度低于正常组(P<0.05)。低氯血症组患者住院时间明显增加(P<0.05),院内死亡风险升高(OR为4.10,95%置信区间1.22-13.77,P<0.05)。结论:低氯血症增加CHF患者的住院时间及院内死亡风险。Objective： To investigate the association between hypochloremia and hospital stay, as well as in-hospital mortality in patients with chronic heart failure （CHF）. Methods： Three hundred and forty-one patients with CHF were included. Hypochloremia was defined as serum chloride ≤96 mmol/L based on admission serum chloride. Normochloremia was defined as serum chloride 〉96mmol/L. The baseline clinical data were collected and compared between two groups, including age, sex, physical examination, prior medication use, past medical history, laboratory values, hospital stay and number of deaths in hospital. The parameters between the two groups were compared. Results： Hypochloremia was present in 19.65% of patients with CHF. The values in carbon dioxide combing power, blood urea nitrogen, blood urea nitrogen to creatine ratio, uric acid, total bilirubin, the use of loop diuretics and spirolactone, history of diabetes were significantly higher in hypochloremia group （P〈0.05）, and systolic blood pressure and serum sodium were significantly lower than normochloremia group （P〈0.05）. The hospital stays were longer in hypochloremia group than normochloremia group （P〈0.05）. The in-hospital mortality was higher in hypochloremia group than normochloremia group （OR：4.10, 95%CI： 1.22-13.77, P〈0.05）. Conclusion： CHF patients with hypochloremia have a longer hospital stay and significantly higher in-hospital mortality.

关 键 词：心力衰竭 低氯血症 住院时间 院内死亡率 

分 类 号：R541.6[医药卫生—心血管疾病]