摘要
目的在非糖尿病的血液透析人群中,研究新入透析时合并心力衰竭及心力衰竭亚型对远期预后的影响。方法选择138例新入的非糖尿病血液透析患者进行研究。评价血液透析开始1个月内(基线)是否合并心力衰竭,并根据左心室射血分数将心力衰竭患者划分为射血分数下降的心力衰竭和射血分数保存的心力衰竭2个亚组。观察18个月,研究的主要观察终点为全因死亡或心源性死亡,次要终点为住院或心源性住院。结果新入血液透析患者中有35.5%患者合并心力衰竭,射血分数保存的心力衰竭占42.9%。138例患者中,在18个月时死亡、心源性死亡、住院和心源性住院的例数分别为33例、25例、75例和41例。经年龄、是否合并高血压、血红蛋白和白蛋白水平进行校正后,心力衰竭患者较无心力衰竭患者发生死亡、心源性死亡、住院和心源性住院的风险分别增加130.8%、176.3%、121.5%和143.5%。但是,经多变量校正后,两种心力衰竭亚型发生终点事件的风险并没有区别。结论对于新入血液透析时合并心力衰竭的非糖尿病患者,其18个月时死亡和住院的风险都显著高于非心力衰竭的患者,这种风险可能和左心室射血分数是否下降无关。
Objective To investigate the effect of heart failure and subtypes of heart failure on long-term prognosis in new imported non-diabetic hemodialysis patient.Methods One hundred and thirty-eight non-diabetic hemodialysis patients were included.Baseline(within 1 month from hemodialysis onset)heart failures were evaluated and the patients with heart failure were then subdivided into heart failure with reduced ejection fraction or heart failure with preserved ejection fraction.All the included subjects were followed up for 18 months.The primary endpoints were defined as death or cardiac death and the secondary endpoints were defined as hospitalization or cardiac hospitalization.Results Among the 138 patients,35.5%had heart failure at baseline,and among these patients with heart failure,43.8%were complicated with the subtype of heart failure with preserved ejection fraction.After adjusted by age,hypertension,hemoglobin and albumin level,the risks of death,cardiac death,hospitalization and cardiac hospitalization increased 130.8%,176.3%,121.5%and 143.5%respectively in the patients with heart failure compared with those without heart failure.However,these risks between the 2 subtypes of heart failure did not differ after multiple adjustment.Conclusions The risks of death and hospitalization were increased significantly in the new imported non-diabetic hemodialysis patients with heart failure than those without.However,the increased risks seemed not to be associated with the left ventricular ejection fraction.
出处
《中华临床医师杂志（电子版）》
CAS
2012年第17期5122-5125,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
肾透析
心力衰竭
预后
射血分数
Renal dialysis
Heart failure
Prognosis
Ejection fraction
