老年病人低镁血症与慢性心力衰竭的相关性

ASSOCIATION BETWEEN HYPOMAGNESEMIA AND CHRONIC HEART FAILURE IN ELDERLY PATIENTS

目的探讨老年人低镁血症与慢性心力衰竭的关系。方法选择2016年3月—2018年3月我院住院治疗的老年慢性心力衰竭病人107例(心衰组),选择同期入院的非心力衰竭病人91例作为对照组,收集两组病人临床资料,分析低镁血症与慢性心力衰竭的相关性。根据血镁水平,将107例心力衰竭病人分为低镁血症组(Mg^2+<0.75 mmol/L)13例和正常血镁组(Mg^2+0.75~1.25 mmol/L)94例,应用Logistic回归方法分析血镁水平与心功能状态及预后的关系。结果心衰组血镁水平低于对照组,差异有统计学意义(t=4.647,P<0.05)。多因素Logistic回归分析显示,血镁是慢性心力衰竭的危险因素(OR=0.485,P<0.05)。慢性心力衰竭病人低镁血症组与正常血镁组间心功能分级、N末端B型钠尿肽前体(NT-proBNP)、左心室射血分数(LVEF)相比较差异有统计学意义(Z=-3.515^-2.008,P<0.05),两组再入院率及病死率比较差异亦有统计学意义(χ^2=6.583、5.206,P<0.05)。结论低镁血症可能是老年病人慢性心力衰竭的危险因素,老年慢性心力衰竭合并低镁血症病人心功能状态及预后更差。

Objective To investigate the association between hypomagnesemia and chronic heart failure(CHF)in elderly patients.Methods A total of 107 elderly patients with CHF who were hospitalized and treated in our hospital from March 2016 to March 2018 were enrolled,and 91 patients without heart failure who were hospitalized during the same period of time were enrolled as control group.Related clinical data were collected to analyze the association between hypomagnesemia and CHF.According to the serum level of magnesium,107 elderly patients with CHF were divided into hypomagnesemia group(Mg^2+<0.75 mmol/L)with 13 patients and normal serum magnesium group(Mg^2+0.75-1.25 mmol/L)with 94 patients,and a Logistic regression analysis was used to investigate the association of serum magnesium level with cardiac function and prognosis.Results The CHF group had a significantly lower serum magnesium level than the control group(t=4.647,P<0.05).The multivariate logistic regression analysis showed that serum magnesium was a risk factor for CHF(OR=0.485,P<0.05).There were significant diffe-rences between the hypomagnesemia group and the normal serum magnesium group in cardiac functional grading,N-terminal pro-brain natriuretic peptide,and left ventricular ejection fraction(Z=-3.515 to-2.008,P<0.05),and there were also significant differences in readmission rate and mortality rate(χ^2=6.583,5.206;P<0.05).Conclusion Hypomagnesemia may be a risk factor for CHF in elderly patients,and the elderly patients with CHF and hypomagnesemia tend to have poorer cardiac function and prognosis.