二氧化碳结合力与老年非缺血性扩张型心肌病患者院内死亡的相关性  

Relationship between Carbon Dioxide Combining Power and In-hospital Mortality among Elderly Patients with Non-ischemic Dilated Cardiomyopathy

作　　者：刘耀新 洪万紫 李心怡 邵思思 莫元曦 舒芬 王心怡 程雨琪 蒋磊 谭宁[1,2] LIU Yaoxin;HONG Wanzi;LI Xinyi;SHAO Sisi;MO Yuanxi;SHU Fen;WANG Xinyi;CHENG Yuqi;JIANG Lei;TAN Ning(School of Medicine,South China University of Technology,Guangzhou 510006,China;Department of Cardiology,Guangdong Provincial People′s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510080,China)

机构地区：[1]华南理工大学医学院,广州510006 [2]南方医科大学附属广东省人民医院心内科(广东省医学科学院),广州510080

出　　处：《岭南心血管病杂志》2023年第4期414-419,共6页South China Journal of Cardiovascular Diseases

基　　金：国家自然科学基金面上项目(项目编号:82170339);国家自然科学基金面上项目(项目编号:82270241)

摘　　要：目的探讨入院时二氧化碳结合力(carbon dioxide combining power,CO_(2)CP)水平预测老年非缺血性扩张型心肌病(nonischemic dilated cardiomyopathy,NIDCM)患者预后的能力。方法本研究纳入了2010年1月至2019年12月在广东省人民医院接受NIDCM治疗的1084例老年患者为研究对象。根据入院时CO_(2)CP水平分为低CO_(2)CP组(CO_(2)CP≤23.9 mmol/L,n=364)、正常CO_(2)CP(24.9 mmol/L<CO_(2)CP≤26.9 mmol/L,n=363)、高CO_(2)CP组(CO_(2)CP>26.9 mmol/L,n=357)。采用单因素和多因素Logistic回归分析对老年NIDCM院内死亡相关因素进行分析。使用受试者工作特征曲线(receiver operating characteristic curve,ROC)评价入院时预测老年NIDCM院内死亡的能力。结果与高CO_(2)CP组及正常CO_(2)CP组患者比较,CO_(2)CP降低组患者的院内病死率更高,差异有统计学意义(P<0.05)。单因素和多因素Logistic回归分析显示CO_(2)CP降低是老年NIDCM患者院内死独立危险因素(OR=0.899,P=0.035)。ROC分析显示CO_(2)CP降低对老年NIDCM患者院内死亡有较好的预测能力(曲线下面积为0.700,95%CI:0.608~0.792,P<0.001)。结论入院时CO_(2)CP降低与老年NIDCM患者的院内死亡显著相关,可以作为识别高危老年NIDCM患者的一个简单指标。Objectives To investigate the ability of carbon dioxide combining power(CO_(2)CP)levels at admission on the prognosis of elderly patients with non-ischemic dilated cardiomyopathy(NIDCM).Methods This study included 1084 elderly patients who received treatment for NIDCM at Guangdong Provincial People′s Hospital from January 2010 to December 2019.The patients were categorized into three groups based on their admission CO_(2)CP levels:low CO_(2)CP group(CO_(2)CP≤23.9 mmol/L,n=364),normal CO_(2)CP group(24.9 mmol/L<CO_(2)CP≤26.9 mmol/L,n=363),and high CO_(2)CP group(CO_(2)CP>26.9 mmol/L,n=357).Univariate and multivariate Logistic regression analyses were conducted to identify factors associated with in-hospital mortality in elderly NIDCM patients.The receiver operating characteristic curve(ROC)was used to assess the predictive ability of CO_(2)CP for in-hospital mortality in elderly NIDCM patients.Results Patients in low CO_(2)CP group had a higher in-hospital mortality rate than that in normal CO_(2)CP group and high CO_(2)CP group(P<0.05).Univariate and multivariate Logistic regression analyses showed that low CO_(2)CP was an independent risk factor for in-hospital mortality in elderly NIDCM patients(OR=0.899,P=0.035).ROC analysis demonstrated that low CO_(2)CP had a good predictive ability for in-hospital mortality in elderly NIDCM patients(area under the curve=0.700,95%CI:0.608-0.792,P<0.001).Conclusions Low CO_(2)CP significantly associates with in-hospital mortality in elderly NIDCM patients and can serve as a simple indicator for identifying high-risk elderly NIDCM patients.

关 键 词：心肌病 二氧化碳结合力 预后 院内病死率 

分 类 号：R542[医药卫生—心血管疾病]