摘要
目的分析左心室射血分数降低心力衰竭(HFr EF)患者出院后1年内再入院的危险因素。方法回顾性分析我院2010年1月-2013年6月就诊的200例HFr EF患者相关资料,均接受"金三角"方案(贝那普利+螺内酯+美托洛尔)治疗,出院后随访1~3年,以出院后1年内再入院为本研究终点,据此将其分为再入院组与对照组(未入院),比较两组性别、年龄、吸烟史、高血压病史、糖尿病病史、实验室相关指标包括B型氨基端利钠肽原(NT-pro BNP)、超声心动图检查指标等,并进行Logistic多因素回归分析。结果 200例患者出院后1年内再入院80例,占40.00%;再入院组与对照组在高血压、左心室内径、二尖瓣反流、三尖瓣反流、心包积液、前次入院心功能分级、院后用药依从性、NT-pro BNP、LVEF方面比较差异有统计学意义(P<0.05);Logistic多因素回归分析显示高血压、二尖瓣反流、心包积液、前次入院心功能分级为HFr EF患者院后1年内再入院独立危险因素,而出院后用药依从性高为其保护因素。结论 HFr EF经"金三角"方案治疗后均好转出院,但出院后1年内部分患者再入院,高血压、二尖瓣反流、前次入院心功能分级等为HFr EF患者出院后1年内再入院独立危险因素,出院后用药依从性高为保护因素。
Objective To analyze the risk factors of readmission for patients with heart failure and reduced left ventricular ejection fraction（ HFr EF） within 1 year after discharge from hospital. Methods The related data of two hundred patients with HFr EF who had been admitted to our hospital between January 2010 and June 2013 was retrospectively analyzed.All the patients were treated with the Golden Triangle regimen（ benazepril combined with spironolactone and metoprolol）,and they were followed up for 1-3 years after discharge.With readmission within 1 year after discharge as the end point of the study,the subjects were divided into the readmission group and the control group（ not admitted）.Gender,age,smoking history,history of hypertension,history of diabetes,laboratory related indexes,including B type N-terminal pro-brain natriuretic peptide（ NT-pro BNP） and echocardiography indexes,were compared between the two groups.The significant single factors were analyzed by multivariate logistic regression analysis.Results Eighty of the two hundred cases were readmitted within 1 year after discharge,accounting for 40.00%.There was significant difference between the readmission group and the control group in hypertension,left ventricular inner diameter,mitral regurgitation,tricuspid regurgitation,pericardial effusion,cardiac function grading during the previous hospitalization,compliance after medication,NT-pro BNP and LVEF（ P 0. 05）. Multivariate logistic regression analysis showed that hypertension,mitral regurgitation,pericardial effusion and cardiac function grading druing previous hospitalization were independent risk factors of readmission for patients with HFr EF within 1 year after discharge while high compliance after admission was a protective factor.Conclusion Patients with HFr EF can be cured using the Golden Triangle regimen. One year after discharge,some patients are readmitted.Hypertension,mitral regurgitation and cardiac functional grading during previous hospitalization are independent risk factors while high drug compliance after admission is a protective factor.
出处
《解放军预防医学杂志》
CAS
2017年第8期899-901,946,共4页
Journal of Preventive Medicine of Chinese People's Liberation Army
基金
海南省教育厅高等学校科学研究项目(No.Hnky2015-33)
关键词
左心室射血分数心力衰竭
再入院
危险因素
left ventricular ejection fraction
heart failure
readmission
risk factors
