前白蛋白对急性心力衰竭患者短期死亡率和再入院率的影响  

Effects of prealbumin on short-term mortality and readmission rates in patients with acute heart failure

作　　者：姜永日[1] 王柏春[1] JIANG Yong-ri;WANG Bai-chun(Department of Cardiovascular Surgery,The Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第四医院心脏大血管外科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2018年第3期254-258,共5页Journal of Harbin Medical University

摘　　要：目的研究急性心力衰竭患者血清前白蛋白水平与心因性短期死亡率和再住院率的关系。方法入选194例符合条件的急性心力衰竭患者,分为正常前白蛋白组(> 0. 2 g/L)和低前白蛋白组(≤0. 2 g/L)。分析两组间60天的死亡率和再入院率。结果 194例患者中,低前白蛋白组81例(42%),正常前白蛋白组113例(42%),平均年龄65. 6岁(58. 9～70. 32,P=0. 415),男性77例(40%,P=0. 482)。平均随访60天后,33例(17%,P=0. 032)死亡,69例(47. 9%,P=0. 476)再次入院。低前白蛋白组死亡率较高。此外,高龄、心力衰竭病史、NT-proBNP升高、出现合并症、心功能降低和住院时间延长等因素也与死亡风险升高有关。结论前白蛋白水平降低在急性心力衰竭患者中常见,与较高的短期死亡率有关。Objective To evaluate if low prealbumin levels have effect on admission predict mortality and readmissions in patients with acute heart failure （HF）. Methods We conducted a prospective observational cohort study including 194 patients hospitalized for acute HF. Patients were diveded into two groups according to prealbumin levels： ＂normal＂ prealbumin （ 〉 0. 2 g/L） and ＂low＂ prealbumin （≤0. 2 g/L）. End-points were mortality and readmissions （heart related） at 60 days. Results Out of 194 patients, 81 （42%） had low and 113 （42%） had normal prealbumin levels with mean age of 65.6 （58.9 -70. 32, P = 0. 415 ） years and 77 males （40%, P =0. 482）. After a median 60 days of follow-up, 33 （ 17%, P = 0. 032） patients died and 69（47.9% , P =0. 476） were readmitted. Mortality was higher in the low prealbumin group. In the multivariate analysis the following variables were associated with mortality or readmission： older age, exacerbated chronic HF, higher comorbidity, low systolic blood pressure and hemoglobin values and higher pro brain natriuretic peptide levels. Conclusion Low prealbumin is common in patients with acute heart failure and it is associated with a higher short-term mortality.

关 键 词：前白蛋白 急性心力衰竭 死亡率 再入院率 

分 类 号：R541.6[医药卫生—心血管疾病]