不同血清钠水平对舒张性心力衰竭患者预后影响

Different Serum Sodium Levels Affecting Long-term Prognosis in Patients with Diastolic Heart Failure

目的探讨不同血清钠水平对舒张性心力衰竭患者长期预后的影响。方法选取120例舒张性心力衰竭患者,依据不同的血清钠水平分为高血钠组20例、正常血钠组50例及低血钠组50例,观察各组临床资料、实验室指标及预后。结果与正常血钠组、高血钠组相比,低血钠组年龄偏大、心功能分级(NYHA)更高,入院心率更快,但入院时舒张压、收缩压更低。与正常血钠组、高血钠组比较,低血钠组红细胞、血红蛋白、白蛋白、前白蛋白、甘油三酯、血氯和脑钠肽更低,肌酐、尿素氮更高,低血钠组病死率71.4%高于正常血钠组21.4%和高血钠组7.2%,上述差异均有统计学意义(P<0.05)。结论正常血钠和高血钠的舒张性心力衰竭患者预后相近,低血钠的舒张性心力衰竭患者长期预后的病死风险增加,二者密切相关。

Objective To investigate the effect of different blood sodium levels on long-term prognosis of patients with diastolic heart failure. Methods 120 patients with diastolic heart failure according to different levels of serum sodium were divided into high blood sodium group 20 patients and normal group50 patients and the low sodium blood serum sodium 50 patients. Clinical data,laboratory indexes and prognosis were all observed. Results Compared with the other two groups,the patients in the low sodium group were older,the NYHA classifications were higher,and the admission heart rate was faster.However,diastolic blood pressure and systolic blood pressure were lower on admission. Compared with the other two groups,the levels of erythrocyte,hemoglobin,albumin,prealbumin,triglyceride,blood chlorine and brain natriuretic peptide were lower in low sodium group. Creatinine in left ventricular endsystolic volume was higher in urea nitrogen and low sodium group mortality was significantly higher than normal sodium and high sodium group. The difference was statistically significant（ P 0. 05）.Conclusion Normal serum sodium and the prognosis of patients with diastolic heart failure of high blood sodium are very close,while low serum sodium and the long-term prognosis of patients with diastolic heart failure are increased risk of death. The two are closely related.