影响心衰患者再入院的多因素分析

The influential factors regarding the rehospitalization of patients with heart failure

目的探讨影响心力衰竭患者再住院的因素。方法对136例心力衰竭患者病因、病程、年龄、临床因素、血流动力、生化、并发症、治疗进行单因素分析,然后对有意义的单因素用COX回归模型进行多因素综合分析。结果经单因素分析:性别、病因、年龄、入院时症状、入院时体征、美国纽约心脏病协会心功能分级(NYHA分级)、左室舒张末期短轴长度(LVDD)、左室收缩末期短轴长度(LDSD)、左室射血分数(LVEF)值、心率变异性、血清脑纳肽(BNP)、血清心肌肌钙蛋白(CTnI)、血肌酐(Cr)、血糖、出院前6min步行试验、出院后服用血管转换酶抑制剂(ACEI)、出院后服用β受体阻滞剂,对心衰患者再住院有显著影响。再经COX回归多因素综合分析结果显示病因、年龄、心功能分级(NYHA分级)、LVEF值、LVDD、LDSD、BNP、Cr、血糖、出院前6min步行试验10项因素,对心衰患者再住院有显著影响。结论136例患者中位再住院时间为2个月(0.25～13.10个月)。经COX回归多因素综合分析,病因、年龄、心功能分级(NYHA分级)、LVEF值、LVDD、LDSD、BNP、Cr、血糖、出院前6min步行试验10项为影响再住院的主要因素。

Objective To explore the influential factors regarding the rehospitalization of patients with heart failure. Methods Single factor analysis was conducted on etiology, duration of disease, age, clinical factors, hemodynamics, biochemistry, complication and treatment situation among 136 patients with heart failure. Then Cox regression model was employed to analyze the multi-factors influencing the rehospitalization. Results Single factor analysis was conducted on seventeen factors sach as gerder, etiology, age, sign. When in hospital when symptom, in hospital symptom, NYHA level, LVEFvalue, LVDD, LVSD, BNP, Cr, blood glucose, 6-minute walking test before hospital discharge and discharged after taking ACEI,and discharged after taking B-blocker there were apparent influences rehospitalization. Of patients with heart failure. Via COX regression analysis showed that etiology, age, NYHA level, LVEF value, LVDD, LDSD, BNP, Cr, blood glucose, 6-minute walking test before hospital discharge were the main factors influencing the rehospitalization. Conclusion The median rehospitalization duration was 2 months （0.25-13.1）. Cox regression analysis showed that etiology, age, NYHA level, LVEF value, LVDD, LDSD, BNP, Cr, blood glucose, 6-minute walking test before hospital discharge were the main factors influencing the rehospitalization.