Child-Pugh肝功能分级在老年心力衰竭患者严重程度和预后评估中的应用  

Application of Child-Pugh liver function grading in the evaluation of severity and prognosis in the elderly patients with heart failure

作　　者：谢娟 XIE Juan(Department of Special Medical Care,Nanchong Central Hospital,The Second Clinical Medical College,North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]南充市中心医院·川北医学院第二临床学院特需医疗科,四川南充637000

出　　处：《中国现代医生》2020年第11期34-37,46,共5页China Modern Doctor

摘　　要：目的探讨Child-Pugh肝功能分级在老年心力衰竭患者严重程度和预后评估中的应用。方法纳入2017年1月~2018年9月于南充市中心医院老年病科已确诊为心力衰竭的患者132例,按照Child-Pugh肝功能的得分将患者分为3个等级:A级、B级、C级,观察记录三组患者的临床特征、肝功能分级与心衰严重程度指标如NYHA分级、NT-proBNP、LVEF的关系,住院时间及患者出院后随访1年的全因死亡率。结果入院的心力衰竭患者中,Child-Pugh A级占比最多;病史特征上,Child-Pugh A、B级心力衰竭患者以合并冠心病病史居多,而Child-Pugh C级心力衰竭患者以合并扩心病病史居多(P<0.05)。Child-Pugh肝功能分级越高,其心衰的NYHA的分级及NT-proBNP的水平也越高,同时LVEF的水平越低(P<0.05)。Child-Pugh肝功能分级越高,心衰患者的住院时间越长,随访1年的全因死亡率越高(P<0.05)。结论肝功能损伤在老年心力衰竭患者中比较常见,Child-Pugh肝功能分级可用于判断老年心力衰竭患者的严重程度,在长期随访中对老年心力衰竭患者的预后有较好的预测价值。Objective To investigate the application of Child-Pugh liver function grading in the evaluation of severity and prognosis of elderly patients with heart failure.Methods 132 patients who had been diagnosed with heart failure in the geriatrics department of Nanchong Central Hospital from January 2017 to September 2018 were included.According to the Child-Pugh liver function score,the patients were divided into 3 grades:A,B,and C.The relationships of clinical characteristics,liver function grading,and heart failure severity indicators such as NYHA grading,NT-proBNP,and LVEF,the length of hospital stay,and all-cause mortality of patients who were followed up for 1 year after discharge were observed and recorded.Results Among the admitted patients with heart failure,Child-Pugh grade A accounted for the most;In terms of medical history,most heart failure patients with Child-Pugh grade A and B were with a history of coronary heart disease.The majority of heart failure patients with Child-Pugh grade C were with a history of concomitant dilated heart disease(P<0.05).The higher the Child-Pugh liver function grade,the higher the NYHA grade and NT-proBNP level of heart failure,and the lower the LVEF level(P<0.05).The higher the Child-Pugh liver function grade,the longer the length of hospital stay for patients with heart failure,and the higher the all-cause mortality at one year follow-up(P<0.05).Conclusion Liver function injury is more common in elderly patients with heart failure.Child-Pugh liver function grading can be used to judge the severity of elderly patients with heart failure,and has a good predictive value for the prognosis of elderly patients with heart failure in long-term follow-up.

关 键 词：CHILD-PUGH肝功能分级 老年 心力衰竭 严重程度 预后 全因死亡率 

分 类 号：R541.6[医药卫生—心血管疾病]