持续非卧床腹膜透析患者心力衰竭影响因素分析

Influencing factors of heart failure among patients with continuous ambulatory peritoneal dialysis

目的探讨持续非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者心力衰竭发生的影响因素。方法调查158例CAPD患者发生心力衰竭情况及其影响因素;并将可能引起患者心力衰竭的相关因素作为变量进行单因素和多因素的Logistic回归分析,寻找引起CAPD患者心力衰竭的独立危险因素。结果 158例CAPD患者中,发生心力衰竭58例,发生率为36.71%。单因素分析提示,年龄、容量管理水平、血红蛋白、血清前白蛋白、胆固醇、C-反应蛋白、尿素氮是引起患者心力衰竭的相关因素;Logistic回归分析显示,容量管理水平、血清前白蛋白及尿素氮是引起CAPD患者心力衰竭的独立危险因素。结论护士提高CAPD患者容量管理水平,是降低心力衰竭发生率的一种简便、有效、经济的方法;纠正患者营养不良状态及降低尿素氮水平,亦是延缓心力衰竭的有效途径。

Objective To explore the influencing factors of heart failure among patients with continuous ambulatory peritoneal dialysis（CAPD）.Method Clinical data were collected from the histories of 158 patients receiving CAPD to investigate the factors inducing heart failure for the purpose of finding out the potential independent influencing factors using t test or chi-square test for univariate analyses and logistic regression in multivariate analyses.Results The incidence of heart failure was 36.71%among the enrolled CAPD patients.Single factor analysis showed that level of volume management,age,hemoglobin,serum pre-albumin, cholesterol and c-reactive protein were related to heart failure.Analysis of multiple variables logistic regression revealed that levels of volume management,serum pre-albumin and blood urea nitrogen were related to heart failure.Conclusions It is an easy,effective and cheaper way for nurses to increase patients’ability of volume control.The strategy including remedying malnutrition and decreasing the level of uremic toxins might be effective for delayed exacerbation of cardiac function among CAPD patients.