血清钾离子水平与心力衰竭患者院内死亡的关系  

Association of serum potassium with in-hospital death in patients with heart failure

作　　者：王传合[1] 韩苏[1] 佟菲 李影[1] 李志超 崔文佳 孙志军[1] WANG Chuanhe;HAN Su;TONG Fei;LI Ying;LI Zhichao;CUI Wenjia;SUN Zhijun(Department of Cardiology,Shengjing Hospital of China Medical University,Shenyang,Liaoning 110022,China)

机构地区：[1]中国医科大学附属盛京医院心血管科,辽宁省沈阳市110022

出　　处：《中国动脉硬化杂志》2021年第4期327-331,共5页Chinese Journal of Arteriosclerosis

基　　金：辽宁省科学技术计划项目(2018225003)。

摘　　要：目的探讨不同血清钾离子水平对心力衰竭患者院内死亡的影响。方法收集中国医科大学附属盛京医院心内科2013年1月—2018年12月因心力衰竭住院的患者资料,建立回顾性队列研究数据库,使用SPSS 22.0软件进行统计分析,采用独立样本t检验、χ^(2)检验及Logistic回归分析观察不同血清钾离子水平对心力衰竭患者院内死亡的影响。结果9459例心力衰竭患者院内死亡率为3.1%。血清钾离子在4.0~4.49 mmol/L之间院内死亡率最低,为2.3%,<3.5 mmol/L院内死亡率是4.2%,5.0~5.49 mmol/L之间院内死亡率是7.7%,≥5.5 mmol/L院内死亡率是15.1%。通过Logistic回归分析比较,血清钾<3.5 mmol/L及≥5.0 mmol/L院内死亡风险增加,在调整肾小球滤过率,排除肾功能的影响后,仍有同样的结论,且血清钾离子水平越低(<3.5 mmol/L)或越高(≥5.0 mmol/L),院内死亡风险越大。结论血清钾离子水平与心力衰竭患者院内死亡明显相关,血清钾离子水平越低(<3.5 mmol/L)或越高(≥5.0 mmol/L),院内死亡风险越大,血清钾离子水平维持在3.5~4.49 mmol/L之间可能对心力衰竭患者预后更好。Aim To investigate the effect of different serum potassium concentration on in-hospital death in patients with heart failure.Methods Data of patients hospitalized for heart failure was collected in Department of Cardiology,Shengjing Hospital of China Medical University from January 2013 to December 2018 and a retrospective cohort study database was established.SPSS22.0 software was used for statistical analysis,independent sample t test,χ^(2) test and Logistic analysis were used to clasify the effects of different serum potassium levels on in-hospital death of patients with heart failure.Results The in-hospital death of 9459 patients with acute decompensation of chronic heart failure was 3.1%.The in-hospital death was the lowest(2.3%)when serum potassium was between 4.0~4.49 mmol/L,4.2%for serum potassium<3.5 mmol/L,7.7%for serum potassium 5.0~5.49 mmol/L,and 15.1%for serum potassium≥5.5 mmol/L.Univariate Logistic analysis showed that serum potassium<3.5 mmol/L and≥5.0 mmol/L were associated with increased in-hospital death,and the same conclusion was reached after adjusting estimate glomerular filtration rate(eGFR)to exclude the effect of renal function.And the lower(<3.5 mmol/L)or higher(≥5.0 mmol/L)the serum potassium level was,the greater the risk of in-hospital death.Conclusion Serum potassium level was significantly correlated with in-hospital death in patients with heart failure.The lower or higher the serum potassium level was,the greater the risk of in-hospital death.Maintaining serum potassium level between 3.5~4.49 mmol/L might be better for patients with heart failure.

关 键 词：心力衰竭 血清钾离子 院内死亡 

分 类 号：R5[医药卫生—内科学]