血清钠离子浓度联合D-二聚体水平对急性心力衰竭短期预后的预测价值  

Predictive value of serum sodium concentration combined with D-dimer levels in short-term prognosis of acute heart failure

作　　者：刘晓芳[1] 黄建英[1] 石磊[2] LIU Xiao-fang;HUANG Jian-ying;SHI Lei(Department of Cardiology,Laiyang Central Hospital,Yantai,Shandong 265200,China;Department of Neurology,Laiyang Central Hospital,Yantai,Shandong 265200,China)

机构地区：[1]烟台市莱阳中心医院心内科,山东烟台265200 [2]烟台市莱阳中心医院神经内科,山东烟台265200

出　　处：《医药论坛杂志》2025年第5期449-453,共5页Journal of Medical Forum

基　　金：烟台市科技发展计划项目(2017YD028)。

摘　　要：目的分析血清钠离子浓度、D-二聚体水平与急性心力衰竭短期预后的相关性。方法采用队列研究选取2020年6月—2023年6月于烟台市莱阳中心医院心内科治疗的急性心力衰竭患者168例作为研究对象,所有患者均进行90 d的随访,根据是否发生主要心血管不良事件分为发生组(n=47)和未发生组(n=121)。收取患者的临床资料,采用乳胶免疫比浊法测定D-二聚体水平,采用离子选择电极法测定血清钠离子浓度。比较两组患者的临床资料,采用logistic回归分析急性心力衰竭短期预后的影响因素。结果发生组舒张末期左心室内径、心功能分级Ⅲ级及以上人数、谷草转氨酶、白细胞计数、D-二聚体水平均高于未发生组(P<0.05);发生组血红蛋白、白蛋白血清钠离子浓度均低于未发生组(P<0.05);多因素logistic回归分析结果显示,舒张末期左心室内径、谷草转氨酶、白细胞计数、白蛋白、血清钠离子浓度以及D-二聚体水平是急性心力衰竭短期预后的影响因素;血清钠离子浓度、D-二聚体水平预测急性心力衰竭短期预后的曲线下面积(area under curve,AUC)值分别为0.803、0.704,均低于血清钠离子浓度联合D-二聚体预测急性心力衰竭短期预后的AUC值0.944;Log Rank检验结果显示:血清钠离子浓度低水平组患者中发生主要心血管不良事件例数高于血清钠离子浓度高水平组(Log Rank=43.314,P<0.05);D-二聚体低水平组患者中发生主要心血管不良事件例数低于D-二聚体高水平组(Log Rank=23.152,P<0.05)。结论血清钠离子浓度联合D-二聚体水平可作为急性心力衰竭短期预后的有效预测指标。Objective To explore the predictive value of serum sodium ion concentration combined with D-dimer level for short-term prognosis of acute heart failure.Methods A cohort study was used to select 168 patients with acute heart failure who were treated in the cardiology department of Laiyang Central Hospital in Yantai City from June 2020 to June 2023 as the study subjects.All patients were followed up for 90 days and were divided into the occurrence group(n=47)and the non occurrence group(n=121)based on whether major cardiovascular adverse events occurred.Collect clinical data from patients,measure D-dimer levels using latex immunoturbidimetry,and measure serum sodium ion concentration using ion selective electrode method.Compare the clinical data of two groups of patients and use logistic regression to analyze the influencing factors of short-term prognosis in acute heart failure.Results The number of people with end-diastolic left ventricular diameter,heart function gradeⅢor above,aspartate aminotransferase,white blood cell count,and D-dimer levels in the group with the occurrence of the disease were higher than those in the group without the occurrence of the disease(P<0.05);the serum sodium ion concentrations of hemoglobin and albumin in the occurrence group were lower than those in the non occurrence group(P<0.05);the results of multivariate logistic regression analysis showed that end diastolic left ventricular diameter,aspartate aminotransferase,white blood cell count,albumin,serum sodium ion concentration,and D-dimer level were influencing factors for the short-term prognosis of acute heart failure;the area under curve(AUC)values of serum sodium ion concentration and D-dimer level predicting short-term prognosis of acute heart failure were O.803 and 0.704,respectively,which were lower than the AUC value of 0.944 predicted by serum sodium ion concentration combined with D-dimer for short-term prognosis of acute heart failure;the results of the Log Rank test showed that the number of major cardiovascular adve

关 键 词：血清钠离子浓度 D-二聚体 急性心力衰竭 预后 

分 类 号：R541.61[医药卫生—心血管疾病]