慢性心力衰竭并发心律失常的危险因素及对预后的影响  

Risk factors and influence on prognosis of chronic heart failure complicated by arrhythmia

作　　者：张佳嘉 常兴 王月霞 焦伟伟 张晓旭 刘然[1] Zhang Jiajia;Chang Xing;Wang Yuexia;Jiao Weiwei;Zhang Xiaoxu;Liu Ran(Rehabilitation Department of Critical Cardiovascular Diseases,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China;不详)

机构地区：[1]首都医科大学附属北京康复医院心血管重症康复科,北京100144

出　　处：《中国循证心血管医学杂志》2025年第1期120-123,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨慢性心力衰竭并发心律失常的危险因素及对预后的影响。方法回顾性分析2022年1月至2024年5月于北京康复医院收治的100例慢性心力衰竭患者病历资料,根据并发心律失常情况分为并发组(n=38)和未心律失常为对照组(n=62),分析慢性心力衰竭并发心律失常的危险因素及与预后的关系。结果单因素分析显示,两组患者的性别、年龄、吸烟史、高血压史、收缩压、舒张压、心率、心功能分级、心力衰竭病因、血钾(K^(+))、右房内径比较差异无统计学意义(P>0.05);两组体质指数(BMI)、血肌酐、N末端脑钠肽前体(NT-proBNP)、左室舒张末期内径(LVEDD)、左房内径、左室射血分数(LVEF)比较,差异有统计学意义(P<0.05);多因素非条件Logistic分析显示,BMI、血肌酐、NT-proBNP、LVEDD、左房内径、LVEF均是慢性心力衰竭并发心律失常的独立危险因素(P<0.05);并发组心源性死亡、心力衰竭加重再入院及急性冠状动脉综合征发生情况均显著高于对照组,差异有统计学意义(P<0.05);Spearman相关系数分析显示,BMI、NT-proBNP、LVEDD、左房内径水平与慢性心力衰竭并发心律失常患者预后之间呈正相关,血肌酐、LVEF水平与慢性心力衰竭并发心律失常患者预后之间呈负相关(P<0.05)。结论慢性心力衰竭并发心律失常的独立危险因素较多,与预后关系密切,临床应针对危险因素重点关注并予以干预。Objective To discuss the risk factors and influence on prognosis of chronic heart failure(CHF)complicated by arrhythmia.Methods CHF patients(n=100)were retrospectively analyzed in Beijing Rehabilitation Hospital from Jan.2022 to May.2024.All patients were divided,according to status of CHF complicated by arrhythmia,into CHF+arrhythmia group(n=38)and non-arrhythmia group(n=62).The risk factors for CHF complicated by arrhythmia and relationship among them and prognosis were analyzed.Results The results of single-factor analysis showed that the differences in gender,age,smoking history,hypertension history,systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate,classification of heart function,HF cause,serum potassium,right atrial diameter(RAD)had no statistical significance between 2 groups(P>0.05).The differences in body mass index(BMI),serum creatinine(SCr),N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LAD)and left ventricular ejection fraction(LVEF)had statistical significance between 2 groups(P<0.05).The results of multi-factor nonconditional Logistic analysis showed that BMI,SCr,NT-proBNP,LVEDD,LAD and LVEF were independent risk factors for CHF complicated by arrhythmia(P<0.05).The occurrences of cardiac death,readmission due to HF exacerbation and acute coronary syndrome(ACS)were significantly higher in CHF+arrhythmia group than those in non-arrhythmia group(P<0.05).The results of Spearman correlation coefficient analysis showed that BMI,NT-proBNP,LVEDD and LAD were positively correlated to prognosis,and SCr and LVEF were negatively correlated to prognosis in patients with CHF complicated by arrhythmia(P<0.05).Conclusion There are many independent risk factors for CHF complicated by arrhythmia,and they are closely related to prognosis.These risk factors should be paid attention to and intervened in clinical practice.

关 键 词：慢性心力衰竭 心律失常 危险因素 预后 相关性 

分 类 号：R541.6[医药卫生—心血管疾病]