先天性心脏病合并肺动脉高压患者全因死亡的影响因素分析

Analysis about influencing factors of all-cause mortality in patients with congenital heart disease complicated with pulmonary hypertension

目的 分析先天性心脏病(CHD)合并肺动脉高压(PAH)患者全因死亡的影响因素。方法 回顾性分析2015年1月-2017年10月于本院内科收治的186例CHD合并PAH患者的临床资料,收集CHD合并PAH患者全因死亡的影响因素。结果 所有患者随访时间为3年,期间14例(11.02%)患者死亡;单因素Cox回归分析显示:B型利钠肽(BNP)、纽约心脏协会(NYHA)心功能Ⅲ/Ⅳ级是CHD合并PAH患者全因死亡的危险因素(HR=3.865、6.543,P <0.05);多因素Cox回归分析显示:NYHA心功能Ⅲ/Ⅳ级是CHD合并PAH患者全因死亡的独立危险因素(HP=5.128,P <0.05)。结论NYHA心功能Ⅲ/Ⅳ级是CHD合并PAH患者全因死亡的独立危险因素。

Objective To analyze the influencing factors of all-cause mortality in patients with congenital heart disease(CHD)combined with pulmonary arterial hypertension(PAH). Methods The clinical data of 186 patients with CHD combined with PAH admitted to the department of internal medicine in our hospital from January 2015 to October 2017 were retrospectively analyzed, and the influencing factors of all-cause deaths of patients were collected. Results All patients were followed up for 3 years, during which 14patients(11.02%)died. Single factor Cox regression analysis showed that B-type natriuretic peptide(BNP)and Ⅲ/Ⅳ level of cardiac function according to New York heart association(NYHA)were risk factors in patients with CHD combined with PAH for all-cause mortality(HR = 3.865, 6.543, P < 0.05);Multiariable Cox regression analysis showed that the heart function being NYHA class Ⅲ/Ⅳ was independent risk factors of death among patients with CHD and PAH(HP = 5.128, P < 0.05). Conclusion NYHA class Ⅲ/Ⅳ of heart function is an independent risk factor for all-cause death in patients with CHD with PAH.