急性心力衰竭患者死亡危险因素分析  

Analysis of risk factors for death within one year after discharge in patients with acute heart failure

作　　者：熊澜冰 艾怡成 周森宇 刘芬 刘征宇[1] Xiong Lanbing;Ai Yicheng;Zhou Senyu;Liu Fen;Liu Zhengyu(Cardiology department,Hunan Provincial People's Hospital(Hunan Normal University Affiliated First Hospital),Changsha,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)心内科

出　　处：《实用休克杂志（中英文）》2023年第4期211-215,共5页Journal of Practical Shock

摘　　要：目的 探究急性心力衰竭患者死亡危险因素。方法 回顾性分析2021年6月至2022年5月因急性心力衰竭收治本院的128名患者临床资料。依据患者是否死亡将其分为死亡组(n=37)和存活组(n=91),使用COX回归分析影响急性心力衰竭患者死亡的危险因素。结果 128名患者中,男性69例(53.9%),平均年龄为(69.1±10.5)岁,1年内全因死亡率为28.9%,死亡组患者平均年龄更大,肾功能更差,N末端脑钠肽前体(NT-proBNP)水平更高,左室射血分数(LVEF)、高密度脂蛋白胆固醇(HDL-c)和低密度脂蛋白胆固醇(LDL-c)水平较低。在多因素COX回归分析中显示:较低的体重指数(BMI)(HR 0.74,CI:0.49~0.92,P=0.016)、低白蛋白血症[HR 0.69(0.53~0.89),P=0.017],高铁蛋白血症[HR 1.42(1.13~1.84),P=0.009]、高尿酸血症[HR 1.41(1.12~1.78),P=0.018]和NT-proBNP[HR 2.17(1.51~3.57),P<0.001]是急性心力衰竭患者死亡的危险因素。结论 急性心力衰竭的老年患者死亡率很高,较低的BMI、低蛋白血症、高铁蛋白血症、高尿酸血症(UA)、NT-proBNP是AHF患者死亡的危险因素。Objective To explore the risk factors for death in patients with acute heart fail-ure.Methods A retrospective observational analysis was conducted on 128 patients admitted to Hu-nan Provincial People's Hospital from June 2021 to May 2022 due to acute heart failure.According to the patient died or not,they were divided into death group(n=37)and a survival group(n=91).COX regression analysis was used to analyze the risk factors affecting death in patients with acute heart failure.Results Among 128 patients,male accounted for 53.9%(n=69).The average age of patients was(69.1±10.5)y.The all-cause mortality rate within one year was 28.9%.The average age of patients in the death group was older,their renal function was worse,the level of N-terminal pro brain natriuretic peptide(NT-proBNP)was higher,and the levels of left ventricular ejection frac-tion(LVEF),high-density lipoprotein cholesterol(HDL-c),and low-density lipoprotein cholesterol(LDL-c)were lower.Multivariate COX regression analysis showed that lower body mass index(BMI)(HR 0.74,CI:0.49~0.92.P=0.016).hypoalbuminemia[HR 0.69(0.53~0.89),P=0.017],ferritin[HR 1.42(1.13~1.84),P=0.009],hyperuricemia[HR 1.41(1.12~1.78),P=0.018]and NT-proBNP[HR 2.17(1.51~3.57),P<0.001]were risk factors for death in patients with acute heart failure.Conclusions The mortality rate of elderly patients with a-cute heart failure is very high.Lower BMI,hypoproteinemia,ferrinemia,hyperuricemia(UA),NT proBNPare risk factors for death of AHF patients.

关 键 词：急性心力衰竭 危险因素 低白蛋白血症 预后 死亡 

分 类 号：R541.6[医药卫生—心血管疾病]