心源性多浆膜腔积液及其相关因素的对比分析

Multi-cardiac effusion and its related factors

目的通过对比分析心衰患者合并浆膜腔积液的情况,探讨多浆膜腔积液、双侧胸腔积液及无浆膜腔积液患者间心功能、感染、低蛋白血症、肾功能差异,分析上述各种因素与多浆膜腔积液的关系,以明确这些因素对心衰患者的浆膜腔积液的影响。方法将该科近4年内收治的诊断为冠心病、高心病、缺血性心肌病的心功能不全患者依据积液的浆膜腔多少分为多浆膜腔组(3个浆膜腔以上)、双侧胸腔积液组与无浆膜腔积液组,分别统计各组间年龄、性别、心衰程度、血浆蛋白含量、血肌酐、尿素氮及肺部感染情况,并进行显著性检验,比较各组间差异。结果心衰患者的年龄、性别以及肾功能情况对浆膜腔积液的发生影响不大,而心功能受损的程度、合并肺部感染的情况与低蛋白血症,尤其是低白蛋白血症、白球比例倒置与心衰患者的多浆膜腔积液关系密切。而对于没有明显低蛋白血症的患者,双侧胸腔积液多与肺部感染有关。结论心源性多浆膜腔积液与心功能受损程度有关,而积液的浆腹腔数量和腔内积液量与心衰伴发的低白蛋白血症及白球比例下降的程度相关。

Aim To compare the analysis of patients with heart failure combined with serious effusion,and explore the differences among the more serious effusion,bilateral pleural effusion and patients without serious effusion in cardiac function,infection,hypoproteinemia,renal function differences.Relationship between these factors was analyzed to make clear the effection fluid in patients with heart failure.Methods Based on the amount of serious cavity effusions,data of patients with coronary heart disease,hypertensive heart disease,ischemic cardiomyopathy patients with cardiac dysfunction in the past four years were divided into more serious effusion group（above three plasma membrane cavity）,bilateral pleural effusion group and non-serious effusion groups.Statistics were made by age,sex,heart failure and the degree of plasma protein content,serum creatinine,blood urea nitrogen and the lung infection and test of significance was conducted by comparing the difference between the groups.Resuts Age,sex and renal function situation have little effect on multi-cardiac effusion,but the occurrence of serious effusion is related to the extent of damage cardiac function of pulmonary infections and hypoproteinemia,especially the white hypoproteinemia ratio of albumin to globulin inversion in patients with heart failure.For patients with no apparent hypoproteinemia,bilateral pleural effusion appears related more with the lung infection.Conclusion More than cardiac effusion and the degree of cardiac dysfunction dysfunction,and serous cavity effusions and effusion volume and the number of heart failure associated with nypoproteinemia and decreased ratio of albumin to the degree of correlation.