袢利尿剂后6h尿钠排泄量对急性心力衰竭患者临床疗效的预测意义  

Predictive Significance of 6-h Urinary Sodium Excretion after Tab Diuretics on Clinical Outcomes of Patients with Acute Heart Failure

作　　者：王纬经 邱祖红 殷乐 邱炜佳 Wang Wei-jing;Qiu Zu-hong;Yin Le;Qiu Wei-jia(Department of Cardiology,Tongzhou District People's Hospital,Nantong 226300,Jiangsu Province,China)

机构地区：[1]南通市通州区人民医院心内科,江苏南通226300

出　　处：《中外医药研究》2022年第9期18-20,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：2020年度南通市卫生健康委员会科研立项课题(编号:MB2020074)。

摘　　要：目的:探讨急性心力衰竭(AHF)患者使用袢利尿剂后6 h尿钠排泄量对临床疗效的预测意义。方法:选取2021年3月-2022年9月通州区人民医院心内科收治的AHF患者60例为观察对象,所有患者立即给予静脉注射速尿40 mg,收集患者6 h的尿量并测定尿钠量。根据尿钠定量将患者分为高尿钠组(>187 mmol/6 h)18例、中尿钠组(89~187 mmol/6 h)22例、低尿钠组(<89 mmol/6 h)20例。比较三组患者心功能分级、心脏超声指标、血浆B型脑利钠肽(BNP)水平、再住院率和病死率。结果:高尿钠组心功能纽约心脏病协会分级、左室射血分数、左室短轴缩短率及血浆BNP水平优于中尿钠组、低尿钠组,差异有统计学意义(P<0.05),高尿钠组各项指标最优、低尿钠组各项指标均最差;高尿钠组再住院率和病死率低于中尿钠组、低尿钠组,差异有统计学意义(P<0.001),高尿钠组再住院率和病死率最低,低尿钠组再住院率和病死率最高。结论:AHF患者尿钠排泄量高低与患者的心力衰竭程度呈负相关,测量使用袢利尿剂后6 h尿钠排泄量可以对患者的预后进行有效预判。Objective:To investigate the predictive significance of 6-h urinary sodium excretion on clinical outcomes in patients with acute heart failure(AHF)after the use of tab diuretics.Methods:60 patients with AHF admitted to the Department of Cardiology of Tongzhou District People's Hospital from March 2021 to September 2022 were selected as observation subjects.All patients were immediately given intravenous tachyphylaxis 40 mg,and the patients'urine volume was collected for 6 h and the urine sodium amount was measured.The patients were divided into 18 cases in the high sodium urine group(>187 mmol/6 h),22 cases in the medium sodium urine group(89~187 mmol/6 h),and 20 cases in the low sodium urine group(<89 mmol/6 h)according to urine sodium quantification.The cardiac function classification,cardiac ultrasound index,plasma B-type brain natriuretic peptide(BNP)level,rehospitalization rate and morbidity and mortality rate were compared among the three groups.Results:The cardiac function New York Heart Association classification,left ventricular ejection fraction,left ventricular short axis shortening rate and plasma BNP level in the high sodium urine group were better than those in the medium sodium urine group and low sodium urine group,and the difference was statistically significant(P<0.05).All indexes were best in the high sodium urine group and worst in the low sodium urine group.The readmission and death rates in the high sodium urine group were lower than those in the medium sodium urine group and the low sodium urine group,and the differences were statistically significant(P<0.001).The rehospitalization and morbidity and mortality rates were the lowest in the high sodium urine group and the highest in the low sodium urine group.Conclusion:The urinary sodium excretion in patients with AHF was negatively correlated with the degree of heart failure,and the measurement of 6-h urinary sodium excretion after the use of tab diuretics can be a useful prognosis for patients.

关 键 词：心力衰竭 尿钠排泄量 心功能 B型脑利钠肽 

分 类 号：R54[医药卫生—心血管疾病]