慢性心力衰竭患者合并肾功能异常的发生情况分析

Analysis for the incidence of abnormal renal function in patients with chronic heart failure

目的了解慢性心力衰竭患者肾功能异常的发生情况,探讨心肾功能的相互关系。方法选择308例慢性心衰患者(心衰组)和125例心功能正常者(对照组)进行回顾性分析,根据肾小球滤过率(GFR)是否<90 ml·min-1·1.73 m-2将心衰组分为单纯心衰组(n=219)和心肾综合征组(n=89)。对3组研究对象一般资料、基础疾病、化验指标、超声心动图等进行比较分析。结果心衰组患者发生肾功能异常的比率高于对照组,差异有统计学意义(P<0.05)。心肾综合征组肾功能不全分期多为肾功能代偿期和失代偿期。NYHAⅣ级组伴发肾功能不全的比例明显高于NYHAⅡ、Ⅲ级组,差异有统计学意义(P<0.05),而Ⅱ、Ⅲ级组之间差异无统计学意义(P>0.05)。结论慢性心衰患者常合并不同程度的肾功能异常。心肾综合征患者心功能较单纯慢性心衰患者明显减低。随着心功能的减退,肾功能异常发生率明显上升。

Objective To understand the incidence of abnormal renal function in patients with chronic heart failure （ CHF） ,and to explore the correlation between cardiac function and renal function .Methods The data of 308 patients with chronic heart failure （ CHF group ） and 125 healthy subjects （ control group ） were retrospectively analyzed .According to the glomerular filtration rate,whether （eGFR）〈90 ml· min^-1 1.73m^-2 or not,the CHF group was subdivided into simple CHF group （ n =219） and cardiorenal syndrome group （ n =89）.The general data,basic diseases,test indexes,ultrasound cardiograms were analyzed and compared among the three groups .Results The incidence of abnormal renal function in CHF group was significantly higher than that in control group （ P〈0.05）.Most of renal inadequacy staging was at renal function compensatory stage or decompensation stage in cardiorenal syndrome group .The incidence of renal inadequacy in patients with NYHA class Ⅳwas significantly higher than those patients with NYHA classⅡand Ⅲ （ P〈0.05）,however,there was no significant difference between class Ⅱ and class Ⅲ （ P〉0.05）.Conclusion The patients with chronic heart failure are often complicated by abnormal renal function at different degrees .The cardiac function in patients with cardiorenal syndrome is obviously decreased ,as compared with that in patients with simple chronic heart failure .With the decline of cardiac function , the incidence of abnormal renal function is increased significantly .