ICU重症心力衰竭患者预后的影响因素  

Influencing factors of ICU patients with severe heart failure

作　　者：刘玲娜 胡雅琳 LIU Lingna;HU Yalin(ICU,Ji'an Central People's Hospital,Jiangxi Province,Ji'an 343000,China)

机构地区：[1]江西省吉安市中心人民医院ICU,江西吉安343000

出　　处：《中国当代医药》2025年第9期116-119,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212825)。

摘　　要：目的探究ICU重症心力衰竭患者预后的影响因素。方法回顾性分析2022年7月至2023年10月吉安市中心人民医院收治的92例ICU重症心力衰竭患者的临床资料,根据预后情况分为预后不良组(n=19)、预后良好组(n=73),并收集患者一般资料,通过单因素、多因素分析影响ICU重症心力衰竭患者预后相关因素。结果单因素分析结果显示,预后不良组心功能Ⅲ级发生率、左心室射血分数(LVEF)、血红蛋白(Hb)均低于预后良好组,下肢水肿、合并脓毒病发生率、N末端B型钠尿肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)均高于预后良好组,ICU住院时间长于预后良好组,差异有统计学意义(P<0.05);两组的性别、年龄、合并高血压情况比较,差异无统计学意义(P>0.05);多因素logistic回归模型分析结果显示,下肢水肿(β=1.365,OR=3.917,95%CI:1.331~11.527)、心功能分级Ⅳ级(β=1.316,OR=3.727,95%CI:1.298~10.702)、NT-proBNP(β=1.115,OR=3.097,95%CI:1.148~8.332)、hs-CRP(β=1.313,OR=3.795,95%CI:1.372-9.576)、血肌酐(β=0.313,OR=1.367,95%CI:1.133~1.649)合并脓毒症(β=1.870,OR=6.491,95%CI:2.082~20.233)、ICU住院时间久(β=1.598,OR=4.937,95%CI:1.759~13.892)均是ICU重症心力衰竭患者预后不良的独立危险因素,LVEF(β=-0.150,OR=0.861,95%CI:0.788~0.941)、Hb(β=-0.176,OR=0.839,95%CI:0.759~0.927)是ICU重症心力衰竭患者预后不良的独立保护因素(P<0.05)。结论ICU重症心力衰竭患者存在一定预后不良风险,与下肢水肿、心功能分级、LVEF、NT-proBNP、Hb、hs-CRP、合并脓毒症、ICU住院时间均相关。Objective To explore the influencing factors of prognosis in ICU patients with severe heart failure.Methods The clinical data of 92 ICU patients with severe heart failure admitted to Ji'an Central People's Hospital from July 2022 to October 2023 were retrospectively analyzed,and they were divided into poor prognosis group(n=19)and good prognosis group(n=73)according to the prognosis.General data of patients were collected,and the related factors affecting prognosis of ICU patients with severe heart failure were analyzed by univariate and multivariate analysis.Results Univariate analysis showed that the incidence of gradeⅢcardiac function,left ventricular ejection fraction(LVEF)and hemoglobin(Hb)in the poor prognosis group were lower than those in the good prognosis group.The incidence of lower limb edema,sepsis,N-terminal B-type natriuretic peptide precursor(NT-proBNP)and hypersensitive C-reactive protein(hs-CRP)were higher than those in good prognosis group,and the length of ICU stay was longer than that in good prognosis group,the differences were statistically significant(P<0.05).There were no significant differences in gender,age and combined hypertension between the two groups(P>0.05).Multivariate analysis logistic regression model showed that lower limb edema(β=1.365,OR=3.917,95%CI:1.331-11.527),gradeⅣcardiac function(β=1.316,OR=3.727,95%CI:1.298-10.702),NT-proBNP(β=1.115,OR=3.097,95%CI:1.148-8.332),hs-CRP(β=1.313,OR=3.795,95%CI:1.372-9.576),combined with sepsis(β=1.870,OR=6.491,95%CI:2.082-20.233),long stay in ICU(β=1.598,OR=4.937,95%CI:1.759-13.892)were independent risk factors for poor prognosis in ICU patients with severe heart failure,LVEF(β=-0.150,OR=0.861,95%CI:0.788-0.941),Hb(β=-0.176,OR=0.839,95%CI:0.759-0.927)were independent protective factors for poor prognosis in ICU patients with severe heart failure(P<0.05).Conclusion ICU patients with severe heart failure have a certain risk of poor prognosis,which is related to lower limb edema,cardiac function grading LVEF,NT-proBNP,Hb,hs-CRP,s

关 键 词：重症心力衰竭 预后 影响因素 护理策略 

分 类 号：R541[医药卫生—心血管疾病]