急性心力衰竭患者预后现状及其相关危险因素分析

Prognostic status and related risk factors of patients with acute heart failure

目的分析急性心力衰竭(AHF)患者预后现状及其相关危险因素。方法回顾性分析2018年1月至2020年9月本院收治的190例AHF患者的临床资料,统计患者的临床资料[年龄、性别、病程、纽约心功能分级(NYHA)、心率、基础疾病(糖尿病、高血压、冠心病、心房颤动、脑卒中、低钠血症)、住院时间、实验室指标N末端脑钠肽前体(NT-proBNP)、血红蛋白(Hb)、血乳酸水平],分析影响AHF患者预后的危险因素。结果190例AHF患者中死亡15例,因心力衰竭再次入院30例,预后不良发生率为23.68%(45/190)。预后不良患者年龄、心率及NT-proBNP、血乳酸水平、NYHA分级为Ⅳ级、伴心房颤动、脑卒中、低钠血症数量占比均高于预后良好患者,Hb水平低于预后良好患者,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高龄、心率快、NT-proBNP水平高、血乳酸水平高、Hb水平低、NYHA分级为Ⅳ级、伴心房颤动、低钠血症为AHF患者预后不良的危险因素(OR>1,P<0.05)。结论AHF患者预后较差,且与其高龄、心率快、NT-proBNP水平高、血乳酸水平高、Hb水平低、NYHA分级为Ⅳ级、伴心房颤动、低钠血症密切相关,临床可据其予以针对性治疗,以改善患者预后。

Objective To analyze the prognosis status of patients with acute heart failure(AHF)and its related risk factors.Methods The clinical data of 190AHF patients admitted to our hospital from January 2018 to September 2020 were analyzed retrospctively,and the clinical data of patients[age,sex,course of disease,NewYork cardiac function rating(NYHA),heart rate,underlying diseases(diabetes,hypertension,coronary heart disease,atrial fibrillation,stroke,hyponatremia),length of hospital stay,laboratory indicators N-terminal pro-B-type natriuretic peptide(NT-proBNP),hemoglobin(Hb),blood lactate level]were analyzed,and the risk factors affecting the prognosis ofAHF patients were analyzed.Results 15 patients of the 190 AHF patients died,and 30 patients were readmitted to the hospital due to heart failure,with poor prognosis rate of 23.68%(45/190).The proportion of age,heart rate,NT-proBNP,blood lactate level,NYHA gradeⅣ,atrial fibrillation,stroke,and hyponatremia of patients with poor prognosis was higher than that of patients with good prognosis,and Hb level was lower than that of patients with good prognosis,and the difference was statistically significant(P<0.05).The results of multivariate logistic regression analysis showed that older age,fast heart rate,high NT-proBNP level,high blood lactate level,low Hb level,NYHA gradeⅣ,atrial fibrillation,and hyponatremia were risk factors for poor prognosis in AHF patients.(OR>1,P<0.05).Conclusion AHF patients have a poor prognosis,and are closely related to their advanced age,fast heart rate,high NT-proBNP level,high blood lactate level,low Hb level,NYHA gradeⅣ,with atrial fibrillation,and hyponatremia.