充血性心力衰竭患者肾功能不全患病率及与心衰严重程度的关系

Relationship between prevalence of renal insufficiency and severity degree in patients with congestive heart failure

目的回顾性观察充血性心力衰竭(CHF)患者肾功能不全患病率,探讨肌酐(Cr)水平的变化及与射血分数的相关性。方法回顾性收集384例CHF患者的临床资料,根据患者血清肌酐水平将NYHA心功能Ⅱ、Ⅲ、Ⅳ级患者分为肾功能正常组、肾功能不全代偿组和肾功能不全失代偿组。计算各组肾功能不全患病率,探讨Cr水平的变化并与左室射血分数(LVEF)进行相关性分析。结果CHF患者肾功能不全的患病率为39.06%,并且随着NYHA心功能分级的升高,肾功能不全患病率也在升高;随着心功能的恶化,血清Cr浓度在升高,且三组间有统计学差别(P<0.05);Cr与LVEF负相关(r=-0.37,P<0.01)。结论随着NYHA心功能分级的升高,Cr水平在升高,肾功能不全患病率也在升高,提示CHF患者中肾功能不全较常见。

Objective To study retrospectively the prevalence of renal insufficiency and to analyze the relation of Cr with left ventricular ejection fraction（LVEF） in patients with congestive heart failure（CHF）. Methods The data of 384 patients with CHF were collected. Based on Cr level, the patients with heart failure were divided into normal renal function group, compensatory group, decompensation group. The prevalence of renal insufficiency was determined, and the relation of Cr level with LVEF was arualyzed. Results The prevalence of renal insufficiency was 39.06%. With the development of NYHA cardiac functional grading, the prevalence of renal insuffficiency gradually increased（ P 〈 0 . 01 ）. As the cardic function worsened, Cr level gradually increased （P 〈 0.05）. Cr was negatively correlated with LVEF （ r = - 0.37, P 〈 0.01 ）. Conclusion With the devlopment of NYHA cardiac functional grading, the prevalence of renal insufficiency increases. The results indicate that renal insuffiency is a common disease in CHF patients.