摘要
目的:探究急性心力衰竭患者体质量指数(BMI)与院前急救成功率及远期预后的关系。方法:选择2018年4月-2019年7月本院收治的212例急性心力衰竭患者作为研究对象,收集患者临床资料,根据BMI值将患者分为低BMI组(BMI≤21.6 kg/m^2)、正常BMI组(21.6 kg/m^226.7 kg/m^2),统计各组患者院前急救成功率,随访统计患者远期生存情况。结果:单因素分析中各组患者高脂血症比例、缺血性心肌病比例、血清B型氨基端利钠肽原(血清NT-proBNP)水平比较,差异均有统计学意义(P<0.05);各组患者院前急救成功率比较,差异均无统计学意义(P>0.05)。Logistic多因素分析示,NYHA心功能≥Ⅲ级、合并室性心动过速是院前急救失败的独立危险因素(P<0.05)。入组患者随访时间为0.2~32个月,中位随访时间为10个月,Log-rank检验示,正常BMI、中BMI、高BMI组患者生存率高于低BMI组(P<0.05);高BMI组患者生存率高于正常BMI组及中BMI组(P<0.05)。COX多因素分析示,NYHA心功能≥Ⅲ级、合并高脂血症、存在室性心动过速、低BMI是急性心力衰竭患者死亡风险增加的独立危险因素(P<0.05),高BMI是死亡风险增加的保护因素(P<0.05)。结论:BMI与急性心力衰竭患者院前急救效果无明显相关,与治疗后远期生存相关,低BMI增加远期死亡风险,高BMI可降低死亡风险。
Objective:To explore relationship between body mass index (BMI) and success rate of pre-hospital first-aid,long-term prognosis in patients with acute heart failure (AHF).Method:A total of 212 AHF patients who were admitted to the hospital from April 2018 to July 2019 were enrolled.The clinical data were collected.According to different BMI,they were divided into low BMI group (BMI≤21.6 kg/m^2),normal BMI group (21.6 kg/m^2< BMI≤24.2 kg/m^2),middle BMI group (24.2 kg/m^2< BMI≤26.7 kg/m^2) and high BMI group (BMI >26.7 kg/m^2).The success rates of pre-hospital first-aid in all groups were statistically analyzed.The long-term survival of patients was statistically analyzed by follow-up.Result:There were significant differences in hyperlipidemia proportion,ischemic cardiomyopathy proportion,systolic blood pressure,hemoglobin and serum NT-proBNP among all groups (P<0.05).There was no significant difference in success rate of pre-hospital first-aid among all groups (P>0.05).Logistic multivariate analysis showed that NYHA cardiac function grading not lower than grade Ⅲ and ventricular tachycardia were independent risk factors for pre-hospital first-aid failure (P<0.05).The follow-up time and median follow-up time of enrolled patients were 0.2-32.0 months and 10 months,respectively.Log-rank test showed that the survival rate in normal BMI,middle BMI and high BMI group was higher than that in low BMI group (P<0.05).The survival rate in high BMI group was higher than that in normal BMI group and middle BMI group (P<0.05).COX multivariate analysis showed that NYHA cardiac function grading not lower than grade Ⅲ,hyperlipidemia,ventricular tachycardia and low BMI were independent risk factors of increased death risk in AHF patients (P<0.05),while high BMI was a protective factor (P<0.05).Conclusion:There is no significant correlation between BMI and pre-hospital first-aid effect in AHF patients.BMI is associated with long-term survival after treatment.Low BMI increases risk of long-term death,while high BMI can reduce death risk.
作者
廖仍照
吕博文
莫俊强
LIAO Rengzhao;LYU Bowen;MO Junqiang(Xinhui District People’s Hospital of Jiangmen City,Jiangmen 529100,China)
出处
《中国医学创新》
CAS
2020年第7期131-135,共5页
Medical Innovation of China
基金
江门市卫生计生局科学技术研究项目(18A017)。
关键词
急性心力衰竭
体质量指数
院前急救
生存率
预后
Acute heart failure
Body mass index
Pre-hospital first-aid
Survival rate
Prognosis
