低白蛋白血症与射血分数保留心力衰竭患者的相关性及预后分析  

Correlation and prognosis analysis of hypoalbuminemia in patients with heart failure with preserved ejection fraction

作　　者：何微 谢嘉怡[1] 王传合[1] 孙志军[1] He Wei;Xie Jiayi;Wang Chuanhe;Sun Zhijun(Department of Cardiology,Shengjing Hospital of China Medical University,Shenyang 110022,China)

机构地区：[1]中国医科大学附属盛京医院心内科,沈阳110022

出　　处：《中国医师进修杂志》2019年第10期946-950,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的分析低白蛋白血症与射血分数保留的心力衰竭(HFpEF)患者的相关性及预后的关系.方法采用回顾性分析方法纳入2015年1月至2016年12月在中国医科大学附属盛京医院心内科住院的314例HFpEF的住院患者,以血清白蛋白中位数为参考,将患者分为低白蛋白组(白蛋白<35g/L)和正常白蛋白组(白蛋白≥35g/L).通过COX回归分析低白蛋白血症与HFpEF患者预后的相关性.结果低白蛋白组较正常白蛋白组心血管病死率较高[20.2%(20/99)比9.8%(21/215)];两组平均住院时间、院内病死率及心力衰竭再入院率比较差异无统计学意义.单因素COX回归分析表明,正常白蛋白组的心力衰竭再入院的相对危险比为0.554(0.374~0.820),心源性死亡的相对危险比为0.283(0.148~0.538),P值均小于0.05.结论在HFpEF患者中,低白蛋白血症患者的心功能相对较差,病情更重;低白蛋白血症可能是HFpEF患者心源性死亡的危险因素.Objective To investigate the correlation between hypoalbuminemia and heart failure with preserved ejection fraction (HFpEF) and to analyze the prognosis of patients with HFpEF and hypoalbuminemia. Methods Three hundred and fourteen patients with HFpEF who were hospitalized in Department of Cardiology, Shengjing Hospital of China Medical University from January 2012 to December 2013 were analyzed retrospectively. These patients were divided into two groups according to the serum albumin, hypoalbuminemia (<35g/L) group and normal albumin group (≥ 35g/L). The prognostic correlation between hypoalbuminemia and HFpEF was analyzed by COX regression analysis. Results Patients with hypoalbuminemia had a higher mortality: 20.2%(20/99) vs. 9.8%(21/215). There was no significant difference in the average hospitalization time、hospital mortality and readmissions for heart failure between two groups. Univariate COX regression analysis showed that the relative risk ratio of readmissions between normal albumin group and hypoalbuminemia group was 0.554(0.374-0.820), and the relative risk ratio of cardiogenic death was 0.283(0.148-0.538), P < 0.05. Conclusions HFpEF patients with hypoalbuminemia have relative poor heart function;hypoalbuminemia may be a risk factor of cardiac death for patients with HFpEF.

关 键 词：低白蛋白血症 心力衰竭 保留射血分数 

分 类 号：R541.6[医药卫生—心血管疾病]