低钠血症影响心力衰竭住院患者预后的回顾性研究

Prognosis Evaluation of Hyponatremia in Hospitalized Patients with Heart Failure:A retrospective study

目的：回顾性研究低钠血症对心力衰竭住院患者预后的影响。方法：调取2014年7月-2015年11月所有在中山大学孙逸仙纪念医院住院的符合入选标准的心力衰竭患者资料,共152例,分析低钠血症的发生率及其对心衰住院患者住院天数、住院全因死亡率的影响。结果：低钠血症发生率为28/152（18.42%）;低钠血症与正常血钠组在扩张型心肌病基础疾病、入院时收缩压、NYHA心功能分级、血白蛋白水平、血钠浓度、C反应蛋白、NT-pro BNP等方面均有明显差异（P﹤0.05）;低钠血症组全因死亡率明显高于正常血钠组（17.86%vs2.42%,P﹤0.05）。低钠血症组患者住院天数明显长于正常血钠组（15.4天vs 9.4天,P﹤0.05）;在多因素分析中,在校正其他因素影响后,低钠血症依然是住院期间全因死亡（R=1.782,95%CI：1.239-2.699,P﹤0.01）和住院天数延长（R=1.623,95%CI：1.212~2.357,P﹤0.05）的独立危险因素。结论：低钠血症是心衰患者的一种常见水电解质失衡类型。同时低钠血症可明显延长患者住院时间,增加住院期间全因死亡率。

Objective ： To evaluate the prognostic efficacies of hyponatremia in hospitalized patients with heart failure. Methods ：152 patients with heart failure admitted from July 2014 to November 2015 in Sun Yat-Sen Memorial Hospital, Sun Yat- Sen University were anlyzed. The prevalence of hyponatremia on admission as well as its impact on outcome, including length of stay（LOS） and all-caused death in hospital was analyzed. Results ： The prevalence of hyponatremia on admission was 28 / 152（18.42%）. History of dilated cardiomyopathy, systolic blood pressure,NYHA function class, plasma albumin concentration, plasma CRP concentration and N-terminal pro-B type natriuretic peptide levels were significantly different between hyponatremic group and normo-natremic groups（P〈0.01）. Rate of all-caused death in hospital in hyponatremia group was higher than that in normo-natremic groups（17.86% vs 2.42%,P〈0.05）, LOS of hyponatremia patients was significantly longer（15.4d vs 9.4d,P〈0.01）.Multiple Cox proportional hazard analysis showed that hyponatremia remained as independent predictor for all-caused death in hospital and LOS after adjustment for other covaiates. Conclusion ： Hyponatremia is common in patients hospitalized with heart failure and is associated with higher all-caused death in hospital and LOS.