摘要
目的分析慢性心力衰竭(CHF)患者合并肾功能不全的临床特点,探讨CHF患者伴发肾功能不全的危险因素。方法收集就诊于本院心内科的CHF患者385例,其中男性211例,女性174例,平均年龄69.62±8.59岁。采用回顾性对照研究的方法,按照肾小球滤过率估计值(eGFR)将CHF患者分为肾功能不全组[eGFR<60 mL/(min·1.73 m^2)]和非肾功能不全组[eGFR≥60 mL/(min·1.73 m2)]。分析比较两组患者的一般资料、心脏基础疾病、伴随疾病、对比剂应用史、心脏超声参数、肾功能指标、血脂、N末端B型利钠肽前体(NT-proBNP)、D-二聚体、血红蛋白、尿微量白蛋白等实验室检查结果。多因素Logistic回归分析CHF患者合并肾功能不全的危险因素。结果385例CHF患者中合并肾功能不全的发生率约为42.1%。单因素分析结果显示,年龄、NYHA心功能分级、高血压病、贫血、糖尿病、心房颤动在肾功能不全组和非肾功能不全组之间的差异有统计学意义(P<0.05);肾功能不全组血清肌酐、尿素氮、尿酸、胱抑素C和NT-proBNP水平较非肾功能不全组升高;左心室射血分数和血红蛋白水平较非肾功能不全组降低,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄(OR 1.543,95%CI1.067~2.231)、NYHA心功能分级(OR 1.840,95%CI 1.054~3.212)、高血压病史(OR 1.967,95%CI 1.175~3.292)以及胱抑素C(OR 1.989,95%CI 1.027~3.851)与肾功能不全的发生独立相关。结论 CHF患者合并肾功能不全的发生率较高,高龄、NYHA心功能Ⅳ级、高血压病史以及血清高胱抑素C水平是CHF患者合并肾功能不全的独立危险因素。
Aim To analyze the clinical features of patients with chronic heart failure （CHF） complicated with renal insufficiency,and to explore the risk factors of CHF with renal insufficiency.Methods 385 cases of CHF patients who were treated in department of cardiology of our hospital were collected,including 211 males and 174 females,with an average age of 69.62±8.59 years.Applying method of retrospective control study,according to estimated glomerular filtration rate （eGFR）,the CHF patients were divided into renal insufficiency group [eGFR〈60 mL/（min · 1.73 m2）]and non renal insufficiency group [eGFR ≥ 60 mL/（min · 1.73 m2）].The general information,heart basic diseases,concomitant disease,contrast agent application history,echocardiographic parameters,renal function,blood lipids,N-terminal pro-B-type natriuretic peptide （NT-proBNP）,D-dimer,hemoglobin,urine microalbumin and other laboratory examination indexes were analyzed and compared between the two groups.Multivariate Logistic regression was used to analyze the risk factors of CHF patients with renal insufficiency.Results The incidence of renal insufficiency was about 42.1% in 385 patients with CHF.Univariate analysis showed that the differences of age,NYHA heart function classification,hypertension,anemia,diabetes,atrial fibrillation were statistically significant between renal insufficiency group and non renal insufficiency group （P〈0.05）.The levels of serum creatinine,urea nitrogen,uric acid,cystatin C and NT-proBNP in renal insufficiency group were higher than those in non renal insufficiency group,and left ventricular ejection fraction and hemoglobin level were lower than those in non renal insufficiency group （P〈0.05）.Multivariate Logistic regression analysis showed that age （OR 1.543,95%CI 1.067-2.231）,NYHA heart function classification （OR 1.840,95%CI 1.054-3.212）,hypertension （OR 1.967,95%CI 1.175-3.292） and cystatin C （OR 1.989,95%CI 1.027-3.851）were independently associated with renal insufficiency.Conclusion The incidence of renal insufficiency was higher in patients with CHF.The eider age,NYHA heart function Ⅳ classification,hypertension and serum cystatin C were independent risk factors of CHF patients with renal insufficiency.
出处
《中国动脉硬化杂志》
CAS
北大核心
2017年第6期604-609,共6页
Chinese Journal of Arteriosclerosis
关键词
慢性心力衰竭
肾功能不全
危险因素
Chronic heart failure
Renal insufficiency
Risk factor
