冠心病心力衰竭病人肾功能恶化的相关危险因素分析  

Analysis on Risk Factors of Worsening Renal Function in Patients with Chronic Heart Failure of Coronary Heart Disease

作　　者：杨雪卿 王显 Yang Xueqing;Wang Xian(Beijing Hospital of Traditional Chinese Medicine ShunYi Branch, Beijing 101300, China)

机构地区：[1]北京中医医院顺义医院,北京101300 [2]北京中医药大学东直门医院

出　　处：《中西医结合心脑血管病杂志》2017年第20期2521-2525,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨冠心病心力衰竭病人肾功能恶化的相关危险因素。方法将268例慢性冠心病心力衰竭病人根据病程是否发生肾功能恶化分为心肾综合征(CRS)组(n=120)与非CRS组(n=148),详细记录病人的住院病历资料及辅助检查结果,根据文献资料报道和临床资料分析发生肾功能恶化的可能相关因素,以CRS为因变量(0=无,1=有),以单因素分析有统计学意义指标为自变量,采用Logistic多因素回归分析冠心病心力衰竭病人肾功能恶化发生的危险因素。结果通过单因素与Logistic多因素回归分析冠心病心力衰竭病人肾功能恶化发生的高危因素,结果显示心功能Ⅲ级~Ⅳ级、高血压病史、糖尿病病史、肌酐(Scr)及胱抑素C(CysC)为独立危险因素。结论心功能Ⅲ级~Ⅳ级、高血压病史、糖尿病病史、Scr及CysC增高与冠心病心力衰竭病人肾功能恶化关系密切相关。Objective To explore the risk factors of worsening renal function （ WRF）in patients with chronic heart failure （ CHF）ofcoronary heart disease （ CHD） . Methods Two hundreds and sixty eight patients with CHF of CHD were divided into cardiorenalsyndrome （ CRS）group （ n =120）and non CRS group （ n =148）based on the occurrence of WRF. The clinical medical recordsand test results of these hospitalized patients were recorded in detail.At the same time, the possible factors leading to CRS were se -lected with the help of literature and medical records.All the data were pulled into a computer after proofread and then we calculatedresults by conducting the single factor analysis and the multivariate regression analysis. Results The results showed the high riskfactors of WRF in patients with CHF of CHD were New York Heart Association （ NYHA）Classification Ⅲ~Ⅳ, history of diabetes andhypertension,serum creatinine and（ Scr） ,and Cystatin C （ CysC）by a multivariate regression analysis. Conclusion NYHA Ⅲ-Ⅳ,history of diabetes and hypertension, Scr, and CysC were most closely associated with WRF in patients with CHF of CHD.

关 键 词：冠心病 心力衰竭 肾功能恶化 心功能分级 肌酐 胱抑素C 

分 类 号：R541.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]