摘要
目的:探讨充血性心力衰竭(CHF)患者的预后因素。方法:前瞻性研究163例CHF患者临床、血流动力学及心脏收缩功能的预后价值,用多因素Cox回归模型分析各因素对预后的影响。结果:平均随访29个月,心脏性死亡59例,其中猝死34例,泵衰竭死亡19例,心肌梗死死亡6例。生存率分析示主动脉平均压≤90mmHg、肺动脉平均压≥25mmHg、QTc≥440ms、射血分数≤25％及有束支阻滞者,生存率显著降低。多因素分析显示平均主动脉压、平均肺动脉压和QT是心脏性死亡的独立危险因素。结论:低血压、QTc延长及伴肺动脉高压者预后不良,治疗中应防止过度降压和延长心肌复极。
Objective: To investigate the prognostic factors in patients with chronic congestive heart failure. Method: 163 patients with chronic congestive heart failure(83% male, age 59±9 years, left ventricular ejection fraction ≤40% ) were studied prospectively. A detail invasive right and left heart hemodynamie and heart functional study were performed in all patients. Result: During follow - up of 29 ±15 months, there were 59 cardiac death: 19 were due to progressive pump failure , 34 were sudden and 6 were due to myocardial re - infarction, Multivariate Cox proportional harzard analysis identified mean aortic pressure( P <0. 000 1) ,mean pulmonary artery pressure( P = 0. 014 2)and QTc interval( P = 0. 016 7) as independent, statistically significant predictors of total mortality. Kaplan - Meier survival analysis showed that cumulattive survival rate were significantly lower in patients with mean aortic pressure ≤ 90mmHg, mean pulmorlary artery pressure≥ 25mmHg of QTc interval ≥440ms. Conclusion: Low mean aortic pressure, prolong or QTc interval and high mean pulmonary artery pressure defined a subgroup or patients with poor prognosis.
出处
《中国医药导刊》
2000年第2期32-35,共4页
Chinese Journal of Medicinal Guide
