中国全科医学2018，Vol.21Issue(18)：2167-2172,2184,7.DOI:10.3969/j.issn.1007-9572.2018.00.213
高龄严重急性失代偿性心力衰竭患者发生肾功能恶化的影响因素分析及肾功能恶化对其预后的预测价值研究
摘要
Abstract
Objective To determine the associated factors for worsening renal function(WRF) in very old patients with severe acute decompensated heart failure(ADHF) and to examine the value of WRF for predicting the short-term outcome of these patients.Methods We enrolled 108 consecutive very old(age ≥ 80,averaged 87.1) inpatients with severe ADHF from Chinese PLA General Hospital between January 2008 and January 2010.We collected their demographic characteristics and clinical data including anti-heart failure drug treatment.WRF was defined as an increase in serum creatinine levels from the first day to the seventh day after admission >0.3 mg/dl or >25%.All-cause mortality was recorded over the follow-up period of 6 months. Influencing factors of WRF and value of WRF in predicting all-cause mortality were then evaluated in all patients.Results 44 were identified with WRF.Multivariate Logistic regression analysis revealed that baseline eGFR,NT-proBNP and coexistence of CKD were independent predictors for WRF(P<0.05).All-cause mortality rates were 70.5%(31/44)in WRF group and 46.9%(30/64)in non-WRF group.Cox regression analysis found that baseline SBP,hemoglobin,BUN and serum potassium as well as WRF were independent predictors for all-cause mortality(P<0.05).Conclusion Coexistence of CKD was an independent influencing factor of WRF,and WRF increased the risk of all-cause mortality in very old patients with severe ADHF.关键词
心力衰竭/肾功能不全/影响因素分析/预后/预测Key words
Heart failure/Renal insufficiency/Root cause analysis/Prognosis/Forecasting分类
医药卫生引用本文复制引用
伊双燕,骆雷鸣,付士辉,赵韶盼,孙玉青,赵晓茜..高龄严重急性失代偿性心力衰竭患者发生肾功能恶化的影响因素分析及肾功能恶化对其预后的预测价值研究[J].中国全科医学,2018,21(18):2167-2172,2184,7.基金项目
中国军队保健专项科研课题(14BJZ12) （14BJZ12）
