心力衰竭儿童预后的影响因素分析

Analysis of influencing factors of prognosis in children with heart failure

目的探讨影响儿童心力衰竭预后的因素。方法对2016年1月至2018年1月在柳州市人民医院儿科住院的133例心力衰竭患儿根据改良Ross评分进行分级,对患儿的血液学指标N-端脑利钠肽前体(NTproBNP)、红细胞分布宽度(RDW)、高敏C反应蛋白(hsCRP)、白蛋白(ALB)、钠离子(Na+)、钾离子(K+)进行单因素分析,然后用Logistic回归进行多因素综合分析。结果 133例心衰患儿按预后分为死亡组21例及好转组112例,按改良Ross评分分为轻度心衰组(3～6分) 68例、中度心衰组(7～9分) 39例、重度心衰组(10～12分) 26例,其中轻度心衰组死亡率为2.9%(2/68例),中度心衰组为15.3%(6/39例),重度心衰组为50.0%(13/26例)。经单因素分析结果显示,RDW、hsCRP、ALB对心衰患儿的预后有影响(P<0.05),再经Logistic回归进行多因素综合分析,结果显示RDW、ALB因素是影响心衰患儿预后的高危因素(P<0.05)。结论 RDW、ALB是影响心力衰竭患儿预后的危险因素。

Objective To explore the factors affecting the prognosis of children with heart failure. Methods A total of 133 children with heart failure admitted to the Department of Pediatrics at the Liuzhou People＇s Hospital from January 2016 to January 2018 were graded according to the modified Ross score. A single factor analysis was performed on the hematological indexes of children with N-terminal brain natriuretic peptide precursor （NT-proBNP）, red blood cell distribution width （RDW）, high-sensitivity C-reactive protein （hsCRP）, albumin （ALB）, sodium （Na^＋）, and potassium （K^＋）, followed by logistic regression for multivariate analysis. Results These 133 children with heart failure were divided into death group （21 cases） and improved group （112 cases） according to the prognosis. According to the modified Ross score, they were divided into mild heart failure group （3 to 6 points） with 68 cases, moderate heart failure group （7 to 9 points） with 39 cases, and severe heart failure group （10 to 12 points） with 26 cases. Among them, the death rate of mild heart failure was 2.9% （2/68 cases）, moderate heart failure group was 15.3% （6/39 cases）, and severe heart failure group was 50.0% （13/26 cases）. The single factor analysis showed that RDW, hsCRP and ALB had an impact on the prognosis of children with heart failure （P〈0.05）. Logistic regression analysis of multiple factors showed that RDW and ALB were the risk factors affecting the prognosis of children with heart failure （P〈0.05）. Conclusion RDW and ALB are risk factors for the prognosis of children with heart failure.