血清氯离子水平与缺血性心肌病心力衰竭患者死亡风险相关性研究

Correlation between serum chloridion level and mortality risk in patients with ischemic cardiomyopathyheart failure

目的探讨入院时血清氯离子水平与缺血性心肌病心力衰竭患者全因死亡风险的相关性。方法选择2017年1月至2017年12月于河北省人民医院心内科住院缺血性心肌病心力衰竭患者临床资料261例,根据入院时血清氯离子水平以三分位法分为<103 mmol/L组(n=92),103~106 mmol/L组(n=93),>106 mmol/L组(n=76)。平均随访542 d,主要终点事件为全因死亡。探讨入院时血清氯离子水平与全因死亡风险之间的相关性。结果261例心力衰竭患者血清氯离子水平中位数是104(101~107)mmol/L,经过中位数542天的随访,总死亡发生率为34.5%(n=90)。Kaplan-Meier分析显示与103~106 mmol/L组(Log-rank P=0.001)死亡率(26%)和>106 mmol/L组(Log-rank P=0.003)死亡率(25%)相比,<103 mmol/L组死亡率更高(51%)。以103~106 mmol/L组为参照,多因素Cox回归分析显示<103 mmol/L组与死亡风险增加相关(P=0.007,HR:2.063,95%CI:1.219~3.491)。结论入院时较低的血清氯离子水平与缺血性心肌病心力衰竭患者较高全因死亡率相关。

Objective To investigate the correlation between serum chloridion level on admission and allcause mortality risk in patients with ischemic cardiomyopathy-heart failure(ICM-HF).Methods ICM-HF patients(n=261)were chosen from Department of Cardiology in People’s Hospital of Hebei Province from Jan.2017 to Dec.2017 and their clinical materials were collected.According to serum chloridion level on admission,all patients were divided into low-level group(chloridion level<103 mmol/L,n=92),mid-level group(chloridion level from 103 mmol/L to 106 mmol/L,n=93)and high-level group(chloridion level>106 mmol/L,n=76).All groups were followed up for 542 d averagely,and major end-end-point events were all-cause mortality.The correlation between serum chloridion level on admission and all-cause mortality risk was studied.Results The median of serum chloridion level was 104 mmol/L(101~107)in 261 patients.After followed up for 542 d,the total mortality was 34.5%(n=90).The results of Kaplan-Meier analysis showed that the mortality was higher in low-level group(51%)than that in mid-level group(Log-rank P=0.001,26%)and high-level group(Log-rank P=0.003,25%).With mid-level group as a reference,the results of multi-factor Cox regression analysis showed that low-level group was correlated to mortality risk increase(P=0.007,HR=2.063,95%CI:1.219-3.491).Conclusion The lower serum chloridion level on admission is correlated to higher all-cause mortality in ICM-HF patients.