血尿素氮/血肌酐比值与晚期慢性心力衰竭合并肾功能不全患者预后的关系

Relationship between blood urea nitrogen/serum creatinine ratio and prognosis of patients with advanced chronic heart failure complicated with renal dysfunction

目的:探讨血尿素氮/血肌酐比值(BUN/Cr)与晚期慢性心力衰竭(心衰)合并肾功能不全患者预后的关系。方法:回顾性分析1065例晚期慢性心衰合并肾功能不全患者的临床资料,绘制BUN/Cr预测晚期慢性心衰合并肾功能不全患者出院后全因死亡的ROC曲线,确定最佳截断值,根据截断值将患者分为低BUN/Cr组和高BUN/Cr组。比较两组患者的临床资料,采用Kaplan-Meier法绘制两组患者的生存曲线,采用Cox回归分析BUN/Cr与晚期慢性心衰合并肾功能不全患者预后的关系。结果:BUN/Cr的最佳截断值为15,根据最佳截断值将患者分为低BUN/Cr组(BUN/Cr<15)623例和高BUN/Cr组(BUN/Cr≥15)442例。高BUN/Cr组全因死亡率高于低BUN/Cr组(P<0.05)。Cox回归分析结果显示,高BUN/Cr与晚期慢性心衰合并肾功能不全患者全因死亡有关[HR(95%CI)为1.799(1.246~2.598)]。结论:高BUN/Cr的晚期慢性心衰合并肾功能不全患者全因死亡风险增加。

Aim:To investigate the relationship between blood urea nitrogen/serum creatinine ratio(BUN/Cr)and the prognosis of patients with advanced chronic heart failure combined with renal dysfunction.Methods:Clinical data of 1065 patients with advanced chronic heart failure complicated with renal dysfunction were retrospectively analyzed,mapping the ROC curve of BUN/Cr for predicting all-cause death after discharge to determine the optimal cut-off value,and the patients were allocated into low BUN/Cr and high BUN/Cr groups according to the optimal cut-off value.Kaplan-Meier method was used to draw the survival curve of both groups,and Cox regression was used to analyze the relationship between BUN/Cr and the prognosis of patients with advanced chronic heart failure with renal dysfunction.Results:The optimal BUN/Cr was 15,and patients were allocated into low BUN/Cr(BUN/Cr<15)group(n=623)and high BUN/Cr(BUN/Cr≥15)group(n=442).The all-cause death rate was higher in the high BUN/Cr group than that in the low BUN/Cr group(P<0.05).Cox regression analysis showed that high BUN/Cr was associated with all-cause death in patients with advanced chronic heart failure with renal dysfunction[HR(95%CI)were 1.799(1.246-2.598)].Conclusion:Patients with advanced chronic heart failure complicated with renal dysfunction,who have high BUN/Cr have an increased risk of all-cause death.