| 彭旭东,黄厚源,骆雷鸣,等.急性心力衰竭患者院内不良结局的影响因素分析[J].中国临床保健杂志,2025,28(4):482-486. |
| 急性心力衰竭患者院内不良结局的影响因素分析 |
| Factors associated with in-hospital adverse outcomes in patients with acute heart failure |
| 投稿时间：2025-07-16 |
| DOI：10.3969/J.issn.1672-6790.2025.04.010 |
| 中文关键词: 心力衰竭 院内诊疗 药物疗法 治疗失败 保护因素 危险因素 |
| 英文关键词: Heart failure Institutional practice Drug therapy Treatment failure Protective factors Risk factors |
| 基金项目:军队后勤科研项目(20BJZ47) |
|
| 摘要点击次数: 9 |
| 全文下载次数: 7 |
| 中文摘要: |
| 目的 探讨急性心力衰竭(AHF)患者发生院内不良结局的影响因素,为优化临床治疗方案提供参考。方法 回顾性分析2009年1月至2019年12月中国人民解放军总医院住院的1 767例AHF患者资料,依据是否出现不良结局分为不良结局组和对照组。对2组进行比较,并采用logistic回归分析评估不良结局的影响因素。结果 1 767例AHF患者中427例发生院内不良结局,占24.17%。不良结局组男性比例更高、体重指数更低、收缩压(SBP)更低、舒张压(DBP)更低、心率(HR)更高、慢性肾病比例更高、血红蛋白更低、白蛋白(Alb)更低、低密度脂蛋白胆固醇(LDL-C)更高、钠离子浓度更低、使用硝酸酯类药物和重组人脑利钠肽比例更高、使用螺内酯的比例更低(P<0.05)。多因素logistic回归分析显示,HR升高、肌酐(Cr)升高、LDL-C升高、使用硝酸酯类药是AHF患者发生不良结局的危险因素；SBP升高、DBP升高、Alb升高、使用螺内酯是发生不良结局的保护因素。结论 临床医师在AHF患者的治疗中应关注患者入院时HR、Cr、LDL-C、SBP、DBP、Alb指标,并注意患者是否使用硝酸酯类药或螺内酯,针对患者情况采用合理的治疗方案对改善患者短期预后有重要价值。 |
| 英文摘要: |
| Objective To investigate the factors influencing in-hospital adverse outcomes in patients with acute heart failure (AHF) and provide references for optimizing clinical treatment strategies.Methods A retrospective analysis was conducted on the data of 1 767 AHF patients admitted to the Chinese People′s Liberation Army General Hospital from January 2009 to December 2019.Patients were divided into an adverse outcome group and a control group based on the occurrence of adverse outcomes.Comparisons were made between the groups,and logistic regression analysis was used to identify factors influencing adverse outcomes.Results Among 1 767 AHF patients,427 (24.17%) experienced in-hospital adverse outcomes.Compared to the control group,the adverse outcome group had a higher proportion of males,lower body mass index,lower systolic blood pressure (SBP),lower diastolic blood pressure (DBP),higher heart rate (HR),higher prevalence of chronic kidney disease,lower hemoglobin,lower albumin (Alb),higher low-density lipoprotein cholesterol (LDL-C),lower sodium,higher use of nitrate drugs and recombinant human brain natriuretic peptide,and lower use of spironolactone (P<0.05).Multivariate Logistic regression analysis showed that elevated HR,elevated creatinine (Cr),elevated LDL-C,and use of nitrate drugs were risk factors for adverse outcomes,while elevated SBP,elevated DBP,elevated Alb,and use of spironolactone were protective factors against adverse outcomes.Conclusions In the treatment of patients with acute heart failure (AHF),clinicians should pay attention to the indicators such as HR,Cr,LDL-C,SBP,DBP,and Alb at the time of admission.They should also note whether the patient is taking nitrates or spironolactone.Adopting a reasonable drug regimen based on the patient′s condition is of great value in improving their short-term prognosis. |
|
查看全文
|
| 关闭 |
|
|
|