老年慢性肾衰竭患者并发射血分数中间值型心力衰竭影响因素分析  

Analysis of the Influencing Factors of Heart Failure with Mid-range Ejection Fraction in Elderly Patients with Chronic Renal Failure

作　　者：陈霞 刘丽 刘秋艳 Chen Xia;Liu Li;Liu Qiuyan(Nephrology Department,The Third People’s Hospital of Henan Province,Zhengzhou,Henan,450000,China)

机构地区：[1]河南省直第三人民医院肾内科,河南郑州450000

出　　处：《黑龙江医学》2024年第22期2696-2698,2702,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨老年慢性肾衰竭(CRF)患者并发射血分数中间值型心力衰竭(HFmrEF)的影响因素。方法:回顾性分析2021年1月—2023年12月河南省直第三人民医院收治的70例老年CRF患者的临床资料,根据是否合并HFmrEF分为合并HFmrEF组和未合并HFmrEF组。比较两组患者的一般资料、实验室检查、超声心动图指标等,采用单因素和logistic回归分析HFmrEF的影响因素。结果:70例老年慢性肾衰竭患者中,合并HFmrEF组32例(45.7%),未合并HFmrEF组38例(54.3%);合并HFmrEF组的血红蛋白(Hb)、白蛋白(Alb)水平低于未合并HFmrEF组,而尿素氮(BUN)、肌酐(Cr)、尿酸(UA)、C反应蛋白(CRP)水平高于未合并HFmrEF组,差异有统计学意义(t=4.29、4.44、4.00、2.62、4.02、2.93,P<0.05);合并HFmrEF组的左室舒张末期内径(LVEDD)、左房内径(LAD)、左室质量指数(LVMI)高于未合并HFmrEF组,而左心室射血分数(LVEF)、左室舒张功能指数(E/E’)低于未合并HFmrEF组,差异有统计学意义(t=4.43、3.87、3.90、9.37、5.77,P<0.05);logistic回归分析结果显示,Alb(OR=0.82,95%CI=0.71~0.95,P=0.01)、UA(OR=1.12,95%CI=1.03~1.22,P=0.01)、LVEDD(OR=1.15,95%CI=1.06~1.25,P=0.001)和E/E’(OR=0.87,95%CI=0.79~0.96,P=0.01)是老年CRF患者并发HFmrEF的独立影响因素。结论:老年慢性肾衰竭患者并发HFmrEF与营养不良、高尿酸血症、左室扩张和舒张功能障碍有关,应加强对这些因素的监测和干预,以降低心力衰竭的风险。Objective:To explore the influencing factors of heart failure with mid-range ejection fraction(HFmrEF)in elderly patients with chronic renal failure(CRF).Methods:The clinical data of 70 elderly patients with CRF admitted to the hospital from January 2021 to December 2023 were retrospectively analyzed.According to whether they had HFmrEF,they were divided into cornbined HFmrEF group and non-combined HFmrEF group.The general data,laboratory tests,echocardiographic parameters and other factors of the two groups were compared.Univariate and logistic regression analysis were used to analyze the influencing factors of HFmrEF.Results:Among the 70 elderly patients with CRF,32(45.7%)had HFmrEF,and 38(54.3%)did not.The blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA)and C-reactive protein(CPR)levels in the HFmrEF group were higher than those in the non-HFmrEF group(t=4.29,4.44,4.00,2.62,4.02,2.93;P<0.05).The left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LAD)and left ventricular mass index(LVMI)in the HFmrEF group were larger than those in the non-HFmrEF group,while the left ventricular ejection fraction(LVEF)and E/E’in the HFmrEF group were less than those in the non-HFmrEF group(t=4.43,3.87,3.90,9.37,5.77;P<0.05).Multivariate logistic regression analysis showed that Alb(OR=0.82,95%CI=0.71~0.95;P=0.01),UA(OR=1.12,95%CI=1.03~1.22,P=0.01),LVEDD(OR=1.15,95%CI=1.06~1.25;P=0.001)and LVEDD(OR=0.87,95%CI=0.79~0.96;P=0.01)were independent influencing factors of HFmrEF in elderly patients with CRF.Conclusion:The incidence of HFmrEF in elderly patients with CRF is related to malnutrition,hyperuricemia,left ventricular dilation and diastolic dysfunction.These factors should be monitored and intervened to reduce the risk of heart failure.

关 键 词：老年 慢性肾衰竭 射血分数中间值型心力衰竭 影响因素 

分 类 号：R692.5[医药卫生—泌尿科学]