心力衰竭患者并发甲型流感的临床和实验室特征分析

Analysis on the Clinical and Laboratory Characteristics of Heart Failure Patients with Influenza A

目的比较心力衰竭患者和非心力衰竭患者并发甲型流感的实验室检查和临床特征性差异。方法选择2018年10月~2020年5月收治的心血管系统疾病(高血压除外)并发甲型流感患者57例分为心力衰竭组(n=22)和非心力衰竭组(n=35),比较两组患者的年龄、性别、最高体温、发热天数、住院天数、是否并发肺炎以及二者入院时各生化指标的差异。结果心力衰竭组与非心力衰竭组比较,年龄偏高(69.77±10.83岁vs 54.17±16.31岁),降钙素原(procalcitonin,PCT)(3.96±1.91ng/ml vs 0.69±0.36ng/ml)、C反应蛋白(C-reactive protein,CRP)(95.38±88.15mg/L vs 57.56±51.17mg/L)、总胆红素[19.8(10.8,25.6)μmol/L vs 10.9(8.5,15.9)μmol/L]、肌酐(88.24±67.88μmol/L vs 75.65±23.41μmol/L)和尿素氮(6.95±5.78mmol/L vs 4.44±2.19mmol/L)水平更高,住院时间长(11.29±5.88天vs 9.40±4.60天),APACHE-Ⅱ评分高(14.13±1.84 vs 7.92±4.38),二者差异均有统计学意义(t=3.964,2.125,2.295,χ^(2)=-2.282,t=-2.089,-2.321,2.497,2.246,均P<0.05)。结论心力衰竭患者并发甲型流感后易并发肺炎及脓毒症,可造成肝肾功能损伤,病情严重,同时住院时间更长。

Objective To compare the laboratory and clinical characteristics of influenza A in patients with and without heart failure.Methods A total of 57 patients with cardiovascular diseases(except hypertension)and influenza A was selected from October 2018 to May 2020,and divided into the heart failure group(n=22)and the non-heart failure group(n=35).The age,gender,maximum body temperature,fever days,length of hospitalization,whether pneumonia was associated with the two groups,and the biochemical indexes on admission were compared.Results Compared with the non-heart failure group,the heart failure group had higher levels of procalcitonin(3.96±1.91ng/ml vs 0.69±0.36ng/ml),C-reactive protein(95.38±88.15mg/L vs 57.56±51.17mg/L),total bilirubin[19.8(10.8,25.6)μmol/L vs 10.9(8.5,15.9)μmol/L],creatinine(88.24±67.88umol/L vs 75.65±23.41umol/L)and Urea nitrogen(6.95±5.78mmol/L vs 4.44±2.19mmol/L),longer days of hospitalization(11.29±5.88days vs 9.40±4.60days),the difference between the two groups were statistically significant(t=3.964,2.125,2.295,χ^(2)=-2.282,t=-2.089,-2.321,2.497,2.246,all P<0.05).Conclusion Patients with heart failure combined with influenza A have a high risk of sepsis,easy to cause liver and kidney function damage,much more severe conditions and long hospital stay.