青年慢性心力衰竭急性加重患者临床特征及预后的危险因素分析  

Clinical characteristics and prognostic factors of young patients with worsening heart failure

作　　者：高颖[1] 于海荣[1] 张颖[1] 张国勇 江雪 郭彩霞 GAO Ying;YU Hai-rong;ZHANG Ying;ZHANG Guo-yong;JIANG Xue;GUO Cai-xia(Cardiovascular Center,Beijing Tongren Hospital,Capital Medical University,Beijing 100176,China)

机构地区：[1]首都医科大学附属北京同仁医院心血管中心,北京市100176

出　　处：《中国心血管病研究》2023年第6期565-569,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨青年慢性心力衰竭急性加重患者的临床特征及1年内再住院的危险因素。方法连续性纳入2019年1月至2021年12月于首都医科大学附属北京同仁医院因心力衰竭住院治疗并缓解出院的青年患者,依据出院1年内是否因慢性心力衰竭急性加重而再住院将研究对象分为再住院组和非再住院组。对比两组患者的基线资料,采用多因素Cox回归模型分析青年慢性心力衰竭急性加重患者1年再住院率的影响因素。结果 329例患者中再住院组76例(23.1%),非再住院组253例(76.9%)。单因素分析表明,和非再入院组相比,青年慢性心力衰竭急性加重而再入院患者男性、糖尿病、先天性心脏病、陈旧性心肌梗死、扩张型心肌病的比例明显增高。多因素Cox回归分析结果显示,陈旧性心肌梗死(HR=1.765,95%CI1.376~2.932,P=0.026)、先天性心脏病(HR=1.892,95%CI 1.319~2.289,P=0.002)、扩张型心肌病(HR=3.780,95%CI 1.790~4.675,P=0.038)是青年慢性心力衰竭急性加重患者1年内心衰再住院的独立危险因素。结论先天性心脏病、扩张型心肌病、陈旧性心肌梗死与青年慢性心力衰竭急性加重患者非计划再住院风险增加相关。Objective To investigate the clinical characteristics and prognostic factors of young patients with worsening heart failure(WHF).Methods From January 2019 to December 2021,the young patients with heart failure admitted to the cardiovascular center of Beijing Tongren Hospital were enrolled consecutively after remission of symptoms and divided into the readmission group and non⁃readmission group according to whether they were readmitted within one year for WHF.The baseline characteristics were compared and multivariable Cox regression was used to analyze the associated factors of WHF readmission.Results Of 329 young WHF patients,76(23.1%)patients were included in the readmission group,253(76.9%)patients were included in the nonreadmission group.Compared with the non-readmission group,the readmission group was more likely to be male,and had a higher prevalence of diabetes mellitus,congenital heart disease,old myocardial infarction and dilated cardiomyopathy in univariable analysis(all P<0.05).Multivariable Cox regression analysis showed that old myocardial infarction(HR=1.765,95%CI 1.376-2.932,P=0.026),congenital heart disease(HR=1.892,95%CI 1.319-2.289,P=0.002)and dilated cardiomyopathy(HR=3.780,95%CI 1.790-4.675,P=0.038)were the independent risk factors for readmission.Conclusions Congenital heart disease,dilated cardiomyopathy and old myocardial infarction are related to the increased risk of readmission among the young WHF patients.

关 键 词：心力衰竭 青年 再住院 危险因素 预后 

分 类 号：R541.6[医药卫生—心血管疾病]