心力衰竭合并肾功能不全患者的高危因素及再住院率分析

Risk factors and readmission rate of patients with heart failure complicated with renal insufficiency

目的分析心力衰竭患者临床资料、随访资料和心功能情况,探讨心力衰竭合并肾功能不全患者的危险因素及其1年内的再住院率。方法回顾性分析2022年1月至9月咸宁市中心医院收治的278例心力衰竭患者的临床资料,根据肾功能情况,将其分为单纯心力衰竭组(182例)和心力衰竭合并肾功能不全组(96例),两组患者进行规范治疗,多因素logistic回归分析心力衰竭合并肾功能不全患者的影响因素。结果单因素结果显示,两组的性别、吸烟、饮酒、尿酸、血清肌酐、B型钠尿肽、左室射血分数、左心室舒张末径、再住院率比较,差异有统计学意义(P<0.05)。多因素结果显示,高尿酸血症(β=0.005,OR=0.995,95%CI=0.993~0.997)、低射血分数(β=0.972,OR=0.651,95%CI=0.982~1.609)和纽约心脏协会心功能分级差(β=0.625,OR=0.535,95%CI=0.290~0.987)是心力衰竭合并肾功能不全的危险因素,差异有统计学意义(P<0.05)。结论心力衰竭合并肾功能不全患者内再住院率较高,其受多种因素的影响,高尿酸血症、低射血分数和纽约心脏协会心功能分级差是心力衰竭合并肾功能不全的危险因素。

Objective To analyze the clinical data,follow-up data and cardiac function of patients with heart failure,and to explore the risk factors and the rehospitalization rate within 1 year in patients with heart failure complicated with renal insufficiency.Methods The clinical data of 278 patients with heart failure admitted to Xianning Central Hospital from January to September 2022 were retrospectively analyzed.According to renal function,they were divided into simple heart failure group(182 cases)and heart failure combined with renal insufficiency group(96 cases).Both groups of patients were treated with standard treatment.Multivariate logistic analysis of the influencing factors in patients with heart failure combined with renal insufficiency.Results Univariate analysis indicated that gender,smoking,drinking,uric acid,serum creatinine,B-type natriuretic peptide,left ventricular ejection fraction,left ventricular end-diastolic diameter,and re-hospitalization rate between the two groups,the differences were statistically significant(P<0.05).Multivariate results indicated that hyperuricemia(β=0.005,OR=0.995,95%CI=0.993-0.997),low ejection fraction(β=0.972,OR=0.651,95%CI=0.982-1.609)and poor New York Heart Association cardiac function rating(β=0.625,OR=0.535,95%CI=0.290-0.987)were the risk factor for heart failure combined with renal insufficiency,the differences were statistically significant(P<0.05).Conclusion The rate of re-hospitalization is higher in patients with heart failure and renal insufficiency,which is influenced by multiple factors.Hyperuricemia,low ejection fraction and poor cardiac function rating of New York Heart Association are risk factors for heart failure and renal insufficiency.