心力衰竭合并低钠血症患者的临床特征分析及其疗效观察

The Clinical Characteristics Analysis and Curative Effect Observation of Hyponatremia in Patients with Heart Failure

目的分析心力衰竭(简称心衰)合并低钠血症患者的临床特征,观察补钠、利尿治疗后患者的疗效。方法选择心衰合并低钠血症(<135mmol/L)的68例患者作为低钠组,血钠水平正常(135～155mmol/L)的118例心衰患者作为对照组,比较两组患者的一般资料、用药情况,分析低钠组的临床特征;按照补钠、利尿的总原则个体化治疗后,观察其治疗效果。结果两组患者年龄、体质指数(BMI)、左心室射血分数(LVEF)、NYHA心功能分级、氨基末端脑钠肽前体(NT-proBNP)水平比较,差异均有统计学意义(P<0.05)。平均经过6d的治疗后,低钠组58例患者血钠水平恢复至正常,有效率为85.3%。低钠组治疗前后Na+水平、心功能指标比较,差异均有统计学意义(P<0.001)。结论低钠血症更容易出现在高龄、低BMI、心功能差、不合理应用抗心衰药物的患者中,而补钠、利尿的疗效显著。

Objective To analyze the clinical characteristics of heart failure with hyponatremia,observation the efficacy of sodium in patients with diuretic therapy.Methods Selection of congestive heart failure with hyponatremia（135mmol/L） of 68 patients as low sodium group,normal blood sodium level（135~155mmol/L） of 118 cases of heart failure patients as control group,comparison of two groups of patients with general information,medication,clinical features of low sodium group;in accordance with the general principles of individualized treatment,sodium diuresis,observation of its curative effect.Results Two groups of patients with age,body mass index（BMI）,left ventricular ejection fraction（LVEF）,NYHA cardiac functional grading,N-terminal pro-brain natriuretic peptide（NT-proBNP） level,the differences were statistically significant（P0.05）.The average after 6d treatment,low sodium group of 58 patients with serum sodium levels returned to normal,85.3% efficiency.Comparison of heart function indexes of Na＋ levels before and after treatment,low sodium group,the differences were statistically significant（P0.001）.Conclusion Hyponatremia is more prone to these patients who is old age,low BMI,poor cardiac function,unreasonable application of anti-heart failure,the effect of sodium and diuretic is significant.