长期维持性血液透析患者并发心力衰竭的影响因素分析

Analysis of the influencing factors of chronic maintenance hemodialysis patients complicated with heart failure

目的分析长期维持性血液透析患者并发心力衰竭的影响因素。方法回顾性分析2017年1月—2018年6月于赣南医学院第二附属医院长期行维持性血液透析治疗的184例患者的临床资料,根据是否发生心力衰竭分组,将并发心力衰竭患者纳入心力衰竭组(n=65),将未并发心力衰竭患者纳入心功能正常组(n=119)。比较两组一般资料(性别、年龄、透析时间)、血清指标(血清尿素氮、血清白蛋白、血红蛋白、血钙)及合并症(糖尿病、高血压、心肌病、高脂血症)。维持性血液透析患者并发心力衰竭的影响因素分析采用多因素Logistic回归分析。结果两组性别、血清尿素氮、血清白蛋白、血钙比较,差异无统计学意义(P>0.05);心力衰竭组年龄≥70岁占比、透析时间≥1年占比、高血压、心肌病及高血脂症发生率高于心功能正常组,血红蛋白低于心功能正常组(P<0.05)。多因素Logistic回归分析结果显示,年龄、透析时间、高血压、心肌病、高脂血症是维持性血液透析患者并发心力衰竭的影响因素(OR>1,P<0.05);血红蛋白是维持性血液透析患者并发心力衰竭患者的保护因素(OR<1,P<0.05)。结论年龄、透析时间、高血压、心肌病及高血脂症是维持性血液透析患者并发心力衰竭的影响因素。

Objective To analyze the influencing factors of chronic maintenance hemodialysis patients complicated with heart failure.Methods A total of 184 cases of patients with undergoing maintenance hemodialysis treatment were selected from January 2017 to June 2018 in Second Affiliated Hospital of Gannan Medical University,according to whether heart failure occurs or not,patients complicated with heart failure are included in the heart failure group(n=65)and patients not complicated with heart failure are included in the normal heart function group(n=119).General data(gender,age,dialysis time),serum indexes(serum urea nitrogen,serum albumin,hemoglobin,blood calcium)and complications(diabetes,hypertension,cardiomyopathy,hyperlipidemia)were compared between the two groups.Multivariate Logistic regression analysis was used to analyze the influencing factors of maintenance hemodialysis patients complicated with heart failure.Results There was no statistical differences in the gender,blood urea nitrogen,serum albumin,blood calcium between the two groups(P>0.05);The proportion of age≥70,dialysis time≥1 year,the incidence of hypertension,cardiomyopathy,hyperlipidemia in heart failure group were higher than those in normal cardiac function group,while the hemoglobin in heart failure group was lower than that in normal cardiac function group(P<0.05);The multivariate Logistic regression analysis showed that age,dialysis time,hypertension,cardiomyopathy,hyperlipidemia may be the influencing factors for heart failure in patients with maintenance hemodialysis(OR>1,P<0.05);Hemoglobin was the protective factor for heart failure in patients with maintenance hemodialysis(OR<1,P<0.05).Conclusion Age,dialysis time,hypertension,cardiomyopathy and hyperlipidemia are the influencing factors for heart failure in patients with maintenance hemodialysis.