低氯血症对扩张型心肌病患者的预后价值分析  

The prognostic value of hypochloremia in patients with dilated cardiomyopathy

作　　者：李媛媛[1] 王海燕 潘媛媛[1] LI Yuan-yuan;WANG Hai-yan;PAN Yuan-yuan(The Third Unit of Geriatric Internal Medicine/Department of Hypertension Nursing Unit,Sichuan Academy of Medical Sciences&Sichuan Provincial People′s Hospital,Chengdu 610072,China;Department of Cardiology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]四川省医学科学院·四川省人民医院老年内三高血压科护理单元,四川成都610072 [2]广西医科大学第一附属医院心内科,广西南宁530021

出　　处：《实用医院临床杂志》2022年第5期54-57,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨低氯血症对扩张型心肌病患者的预后价值。方法收集420例扩张型心肌病患者的资料,依据实验室参考值,分为低氯血症组(<99 mmol/L)106例和正常血氯组(99~110 mmol/L)314例。比较两组一般资料及生存曲线,构建COX回归模型分析扩张型心肌病患者预后的危险因素。结果低氯血症组患者有更低的血压、血钠,更高的N末端B型利钠肽前体,更高比例的纽约心脏协会III~IV级患者,以及更低比例的血管紧张素系统抑制剂使用(P<0.05)。生存曲线显示,低氯血症组扩张型心肌病患者生存率为54.7%,低于正常血氯组的69.7%(P=0.001)。COX回归分析显示,低氯血症(RR=0.930,95%CI:0.883~0.979,P=0.006)是扩张型心肌病患者全因死亡的独立危险因素。结论低氯血症与扩张型心肌病患者的不良预后密切相关。Objective To explore the prognostic value of hypochloremia in patients with dilated cardiomyopathy.Methods According to laboratory reference values,420 patients with dilated cardiomyopathy were classified into a hypochloremia group(<99 mmol/L,n=106)and a normal chloride group(99~110 mmol/L,n=314).The survival curves between the two groups were compared using the log-rank test.The COX regression model was constructed to analyze the prognostic risk factors of dilated cardiomyopathy.Results Patients with dilated cardiomyopathy in the hypochloremia group had lower blood pressure and serum sodium,higher N-terminal precursor B-type natriuretic peptide(NT-proBNP),and a higher proportion of New York Heart Association class III-IV cases,and a lower proportion of the use of angiotensin system inhibitors.The Kapan-Meier survival curve showed that the survival rate of patients with dilated cardiomyopathy in the hypochloremia group was 54.7%,which was lower than 69.7%in the normal chloride group(P=0.001).COX regression analysis demonstrated that hypochloremia was an independent risk factor for all-cause death in patients with dilated cardiomyopathy after adjustment for other covariates(RR=0.930,95%CI:0.883~0.979,P=0.006).Conclusion Hypochloremia is closely related to poor prognosis of patients with dilated cardiomyopathy.

关 键 词：低氯血症 扩张型心肌病 预后 

分 类 号：R542.2[医药卫生—心血管疾病]