缺血性心力衰竭患者肾功能恶化的相关因素分析

doi:10.20039/j.cnki.10073949.2022.12.006

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缺血性心力衰竭患者肾功能恶化的相关因素分析
DOI:
                        10.20039/j.cnki.10073949.2022.12.006
                    
作者:
                        黄沛森1,2黄沛森
中山大学附属第一医院心内科,广东省广州市 510080;中山大学附属第一医院国家卫生健康委员会辅助循环重点实验室中山大学,广东省广州市 510080
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梁玮昊1,2梁玮昊
中山大学附属第一医院心内科,广东省广州市 510080;中山大学附属第一医院国家卫生健康委员会辅助循环重点实验室中山大学,广东省广州市 510080
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董吁钢1,2,3董吁钢
中山大学附属第一医院心内科,广东省广州市 510080;中山大学附属第一医院国家卫生健康委员会辅助循环重点实验室中山大学,广东省广州市 510080;中山大学附属第一医院血管疾病诊治技术国家地方联合工程实验室,广东省广州市 510080
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刘晨1,2,3刘晨
中山大学附属第一医院心内科,广东省广州市 510080;中山大学附属第一医院国家卫生健康委员会辅助循环重点实验室中山大学,广东省广州市 510080;中山大学附属第一医院血管疾病诊治技术国家地方联合工程实验室,广东省广州市 510080
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作者单位:(1.中山大学附属第一医院心内科,广东省广州市 510080;2.中山大学附属第一医院国家卫生健康委员会辅助循环重点实验室(中山大学),广东省广州市 510080;3.中山大学附属第一医院血管疾病诊治技术国家地方联合工程实验室,广东省广州市 510080)
作者简介:黄沛森,博士,住院医师,研究方向为心力衰竭,E-mail:huangps3@mail.sysu.edu.cn。通信作者刘晨,博士,主任医师,研究方向为心力衰竭,E-mail:liuch75@mail.sysu.edu.cn。
通讯作者:
基金项目:国家自然科学基金面上项目(81770394)

Analysis of related factors of worsening renal function in patients with ischemic heart failure

Author:

HUANG Peisen ^{^1,2}
HUANG Peisen
Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University, Guangdong 510080, China;National Health Commission Key Laboratory of Assisted Circulation Sun Yat-sen University, Guangdong 510080, China
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LIANG Weihao ^{^1,2}
LIANG Weihao
Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University, Guangdong 510080, China;National Health Commission Key Laboratory of Assisted Circulation Sun Yat-sen University, Guangdong 510080, China
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DONG Yugang ^{^1,2,3}
DONG Yugang
Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University, Guangdong 510080, China;National Health Commission Key Laboratory of Assisted Circulation Sun Yat-sen University, Guangdong 510080, China;National Local Joint Engineering Laboratory of Diagnosis and Treatment Technology of Vascular Diseases, Guangzhou, Guangdong 510080, China
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LIU Chen ^{^1,2,3}
LIU Chen
Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University, Guangdong 510080, China;National Health Commission Key Laboratory of Assisted Circulation Sun Yat-sen University, Guangdong 510080, China;National Local Joint Engineering Laboratory of Diagnosis and Treatment Technology of Vascular Diseases, Guangzhou, Guangdong 510080, China
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Affiliation:

1.Department of Cardiology, the First Affiliated Hospital of Sun Yat-sen University, Guangdong 510080, China;2.National Health Commission Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangdong 510080, China;3.National Local Joint Engineering Laboratory of Diagnosis and Treatment Technology of Vascular Diseases, Guangzhou, Guangdong 510080, China)

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摘要:

目的]探索缺血性心力衰竭(HF)患者住院期间肾功能变化的特点。 [方法]回顾性纳入2013年10月—2017年12月在中山大学附属第一医院心内科住院的缺血性HF患者,采用描述统计方法描述患者基线临床特点,并通过多因素Logistic回归模型探索缺血性HF患者发生肾功能恶化(WRF)的相关因素。 [结果]本研究共纳入797名缺血性HF患者,平均年龄(70.5±11.1)岁,其中68.9%为男性；其中22.5%为左心室射血分数(LVEF)降低的HF患者,57.6%为LVEF保留的HF患者。WRF的发生率为18.4%。导致WRF发生的相关因素包括高血肌酐(OR＝1.953,P＜0.001)、高血压史(OR＝1.859,P＝0.025)、低血红蛋白(OR＝0.985,P＝0.002)、高纤维蛋白原(OR＝1.241,P＝0.013)、高血氯(OR＝1.042,P＝0.049)、高血尿酸(OR＝1.002,P＝0.039)及使用呋塞米(OR＝1.773,P＝0.033)。 [结论]缺血性HF患者WRF发生率较高,相关因素较多；临床上需要关注患者肾功能变化,及时控制相关因素,尤其是低血红蛋白、高纤维蛋白原、高血氯、高尿酸等。

关键词:缺血性心力衰竭;肾功能恶化;相关因素

Abstract:

Aim To explore the characteristics of renal function changes in patients with ischemic heart failure (HF) during hospitalization. Methods Patients with ischemic HF hospitalized in the Department of Cardiology, First Affiliated Hospital of Sun Yat-sen University from October 2013 to December 2017 were retrospectively included. Descriptive statistics was used to describe the baseline clinical features of patients. Multivariate Logistic regression model was used to explore the related factors of worsening renal function (WRF) in ischemic HF patients. Results 797 patients with ischemic HF were enrolled in this study, with an average age of (70.5±11.1) years, of whom 68.9% was male. Among them, 22.5% was HF patients with reduced left ventricular ejection fraction (LVEF) and 57.6% was HF patients with retained LVEF. The incidence of WRF was 18.4%. The related factors leading to WRF included high serum creatinine (OR＝1.953, P＜0.001), history of hypertension (OR＝1.859, P＝0.025), low hemoglobin (OR＝0.985, P＝0.002), high fibrinogen (OR＝1.241, P＝0.013), high blood chlorine (OR＝1.042, P＝0.049), high blood uric acid (OR＝1.002, P＝0.039) and using furosemide (OR＝1.773, P＝0.033). Conclusion The incidence of WRF in ischemic HF patients is high, and there are many related factors; Clinically, it is necessary to pay attention to the changes of patients' renal function and control related factors in time, especially low hemoglobin, high fibrinogen, high blood chlorine and high blood uric acid.

Key words:ischemic heart failure; worsening renal function; related factor

参考文献

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黄沛森,梁玮昊,董吁钢,刘晨.缺血性心力衰竭患者肾功能恶化的相关因素分析[J].中国动脉硬化杂志,2022,30(12):1045~1050.

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收稿日期:2021-11-29
最后修改日期:2022-05-01
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在线发布日期: 2022-12-13

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