摘要
目的观察不同严重程度1型心肾综合征(CRS1)对急性心肌梗死(AMI)患者院内死亡的影响。方法采用回顾性方法分析北京友谊医院心血管中心数据库中2094例AMI患者。收集人口学、生化检查、既往病史及入院治疗情况等临床资料。根据心肾功能将CRS1患者分为轻度、中度及重度3级。分层考察CRS1及其不同严重程度与AMI患者院内死亡率之间的关系。Kaplan-Meier生存分析及Cox比例风险回归评估CRS1及其不同严重程度对AMI患者院内死亡的影响。采用SPSS 22.0统计学软件对数据进行分析。结果随着CRS1严重程度的加重,AMI患者的院内全因死亡率逐渐升高(P<0.001)。Kaplan-Meier生存分析显示:CRS1组患者的院内累积生存率低于非CRS1组(P<0.001),并且随着CRS1严重程度的加重,AMI患者的院内累积生存率有下降趋势(P<0.001)。院内发生CRS1是AMI患者院内死亡的独立危险因素(RR=4.233,95%CI 2.013~8.901;P<0.001)。结论院内发生CRS1将对AMI患者的预后产生不良影响。随着CRS1严重程度的加重,AMI患者的院内死亡风险逐渐增加。
Objective To observe the effects of cardiorenal syndrome type 1(CRS1)of different severity on in-hospital mortality in patients with acute myocardial infarction(AMI).Methods A retrospective analysis was conducted of 2094 AMI patients in the Cardiovascular Center of Beijing Friendship Hospital Database Bank.The clinical data were collected for analysis,including demography,biochemical examination,previous medical history and treatment after admission.According to the heart and kidney function,patients were classified as mild,moderate and severe.The relationship between different severity of CRS1 and AMI in-hospital mortality was evaluated.Kaplan-Meier survival analysis and Cox proportional hazard regression were used to assess the effects of CRS1 of different severity on AMI in-hospital mortality.Statistical analysis were performed using SPSS statistics 22.0.Results The all-cause in-hospital mortality increased in AMI patients as CRS1 aggravated(P<0.001).Kaplan-Meier survival analysis showed that the cumulative survival rate in CRS1 group was lower than that in the non-CRS1 group(P<0.001)and decreased with the severity of CRS1(P<0.001).CRS1 occurrence was an independent risk factor for in-hospital death in AMI patients(RR=4.233,95%CI 2.013-8.901;P<0.001).Conclusion The presence of CRS1 adversely affects the prognosis of AMI patients.The risk of in-hospital death increases with the severity of CRS1.
作者
张德强
李虹伟
马清
王珊
杨华昱
刑云利
ZHANG De-Qiang;LI Hong-Wei;MA Qing;WANG Shan;YANG Hua-Yu;XING Yun-Li(Department of Geriatrics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《中华老年多器官疾病杂志》
2020年第12期900-903,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
心肾综合征
1型
预后
严重程度
cardiorenal syndrome,type 1
prognosis
severity
