心力衰竭合并2型糖尿病患者因心力衰竭再住院的影响因素研究

Influencing Factors of Rehospitalization Due to Heart Failure in Patients with Heart Failure and Type 2 Diabetes Mellitus

目的探讨心力衰竭(HF)合并2型糖尿病(T2DM)患者因HF再住院的影响因素。方法选取2019年4月至2020年12月石河子大学医学院第一附属医院心内科收治的341例HF合并T2DM患者,于患者出院后第3、6、12个月对其进行电话随访。随访终点为因HF再住院,随访过程中因HF死亡视为再住院。按照12个月内是否因HF再住院将入组患者分为再住院组(n=105)和对照组(n=236)。收集患者的临床资料,包括一般资料、合并基础疾病情况、实验室检查指标、药物使用情况及心功能指标。采用单因素及多因素Logistic回归分析探讨HF合并T2DM患者因HF再住院的影响因素。结果再住院组白蛋白、血钠低于对照组(P<0.05)。再住院组利尿剂使用率高于对照组,钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂使用率低于对照组(P<0.05)。再住院组N末端脑钠肽前体(NT-proBNP)高于对照组,左心室舒张末期内径(LVEDD)大于对照组(P<0.05)。多因素Logistic回归分析结果显示,合并心房颤动、LVEDD增大是HF合并T2DM患者因HF再住院的危险因素,使用SGLT2抑制剂是HF合并T2DM患者因HF再住院的保护因素(P<0.05)。结论合并心房颤动、LVEDD增大是HF合并T2DM患者因HF再住院的危险因素,使用SGLT2抑制剂是其保护因素。

Objective To study the influencing factors of rehospitalization due to heart failure(HF)in patients with HF and type 2 diabetes mellitus(T2DM).Methods A total of 341 patients with HF and T2DM who were admitted to the Department of Cardiology of First Affiliated Hospital,School of Medicine,Shihezi University from April 2019 to December 2020 were selected.Discharged patients were followed up at the 3rd,6th,and 12th months through the telephone.The end point of follow-up was rehospitalization due to HF,and patients who died for HF during follow-up were considered as rehospitalization.The enrolled patients were divided into the rehospitalization group(n=105)and the control group(n=236)according to whether they were readmitted due to HF within 12 months.The clinical data of the patients were collected,including general data,underlying diseases,laboratory test indexes,medication use and cardiac function indexes.Univariate and multivariate Logistic regression analysis was used to analyze the influencing factors of rehospitalization due to HF in patients with HF and T2DM.Results The levels of albumin and sodium in the rehospitalization group were lower than those in the control group(P<0.05).The use ratio of diuretics in the rehospitalization group was higher than that in the control group,and the use ratio of sodium-glucose transporter 2(SGLT2)inhibitor was lower than that in the control group(P<0.05).The N-terminal pro-brain natriuretic peptide(NT-proBNP)in the rehospitalization group was higher than that in the control group,and left ventricular end-diastolic dimension(LVEDD)was bigger than that in the control group(P<0.05).Multivariate Logistic regression analysis showed that combined with atrial fibrillation and increased LVEDD were risk factors for rehospitalization due to HF in patients with HF and T2DM,and taking SGLT2 inhibitor was a protective factor for rehospitalization due to HF in patients with HF and T2DM(P<0.05).Conclusion Combined with atrial fibrillation and increased LVEDD are risk factors for rehospitalization due to HF in patients with HF and T2DM,and use of SGLF2 inhibitors is a protective factor.