急性充血性心力衰竭合并利尿剂抵抗的危险因素分析  

Analysis of risk factors for acute congestive heart failure complicated with diuretic resistance

作　　者：郑鸿雁 解强 王大宇 吴莎 ZHENG Hongyan;XIE Qiang;WANG Dayu;WU Sha(Department of Cardiology, Panyu District Central Hospital, Guangzhou 511400, China;Panyu District Cardiovascular Institute, Guangzhou 511400, China)

机构地区：[1]广州市番禺区中心医院,广州511400 [2]广州市番禺区心血管疾病研究所,广州511400

出　　处：《广州医药》2019年第4期66-69,共4页Guangzhou Medical Journal

摘　　要：目的分析急性充血性心力衰竭患者中发生利尿剂抵抗的危险因素。方法连续性选取2018年1月-2018年6月于我院住院治疗的急性充血性心力衰竭的患者,其中利尿剂有效组185人及利尿剂抵抗组83人,对比两组患者的临床特点及生物学标志物。结果两组患者中血压、是否合并糖尿病、入院后前24小时尿量、N-端脑利钠尿肽前体、血红蛋白浓度、血钠浓度、尿素氮(BUN)、肾小球滤过率(eGFR)、总胆固醇等因素有统计学差异。通过多因素回归分析,提示eGFR、BUN、入院后前24小时尿量为可预测利尿剂抵抗的危险因素。结论急性充血性心力衰竭患者如果合并肾功能不全、血清BUN升高、早期利尿反应差,则出现利尿剂抵抗可能性大。Objective To analyze the risk factors for diuretic resistance in patients with acute congestive heart failure. Methods Patients with acute congestive heart failure who were hospitalized in our hospital from January 2018 to June 2018 were consecutively selected, including 185 patients in the diuretic effective group and 83 patients in the diuretic resistance group. Clinical features and biomarkers of the patient were collected and compared. Results There are statistical differences in factors, including blood pressure, diabetes mellitus, urine volume in the first 24 hours after admission, NT-proBNP, hemoglobin, blood sodium concentration, blood urea nitrogen(BUN), glomerular filtration rate(eGFR), cholesterol. Multivariate regression analysis indicated that eGFR, BUN, and urine volume during the first 24 hours after admission were risk factors for predicting diuretic resistance. Conclusion Patients with acute congestive heart failure may have diuretic resistance if they have renal insufficiency, elevated BUN, and poor early diuretic response.

关 键 词：心力衰竭 利尿剂抵抗 心肾综合征 

分 类 号：R541.61[医药卫生—心血管疾病]