摘要
目的探讨急性心力衰竭(AHF)患者远期死亡的预测因素。方法连续入选南方医科大学顺德医院2012年6月—12月因AHF住院的患者512例,根据出院后1年内是否死亡分为存活组(n=323)和死亡组(n=189)。记录患者的基线资料。对出院患者进行中位随访时间20.2月的随访,记录全因死亡事件。使用Cox比例风险回归模型分析死亡的危险因素。结果 1年内全因死亡率为36.9%。单因素Cox比例风险回归模型分析提示,AHF病史(HR 1.41,95%CI 1.02~1.95,P<0.05)、心率增快(HR 1.01,95%CI 1.00~1.02,P<0.05)、脑钠肽升高(HR 1.78,95%CI 1.05~3.01,P<0.05)、低白蛋白(HR 0.94,95%CI 0.92~0.97,P<0.001)、低血钠(HR 0.97,95%CI 0.94~1.00,P<0.05)是AHF患者远期死亡的独立预测因素。多因素Cox比例风险回归模型分析提示,AHF病史(HR 1.41,95%CI 1.06~1.88,P=0.018)、心率增快(HR 1.01,95%CI 1.00~1.01,P=0.024)、低白蛋白(HR 0.96,95%CI 0.94~0.99,P=0.003)、低血钠(HR 0.97,95%CI 0.94~0.99,P=0.010)是AHF患者远期死亡的危险因素。结论 AHF病史、心率增快、低白蛋白、低血钠是AHF患者远期死亡的预测因素。
Aim To investigate the predictive factors of long-term death in patients with acute heart failure(AHF). Methods From June 2012 to December 2016, 512 consecutive patients with AHF were enrolled in Shunde Hospital of Southern Medical University. The patients were divided into survival group(n=323) and death group(n=189) according to whether they died within one year after discharge. The baseline data of patients were recorded. Patients were followed-up during the median foullow-up of 20.2 months, and all-cause death events were recorded. Cox proportional hazard regression model was used to analyze the risk factors of death. Results All-cause mortality within one year was 36.9%. Univariate Cox regression analysis showed that AHF history(HR 1.41, 95%CI 1.02~1.95, P<0.05), increased heart rate(HR 1.01, 95%CI 1.00~1.02, P<0.05), elevated brain natriuretic peptide(HR 1.78, 95%CI 1.05~3.01, P<0.05), low albumin(HR 0.94, 95%CI 0.92~0.97, P<0.001), low serum sodium(HR 0.97, 95%CI 0.94~1.00, P<0.05) were independent predictors of long-term death in patients with AHF. Multivariate Cox regression analysis showed that AHF history(HR 1.41, 95%CI 1.06~1.88, P=0.018), increased heart rate(HR 1.01, 95%CI 1.00~1.01, P=0.024), low albumin(HR 0.96, 95%CI 0.94~0.99, P=0.003), low serum sodium(HR 0.97, 95%CI 0.94~0.99, P=0.010) were risk factors for long-term death in patients with AHF. Conclusion AHF history,increased heart rate,low albumin and low serum sodium were predictors of long-term death in patients with AHF.
作者
程宏基
黄裕立
黄伟俊
李美君
童辉煜
申常造
陈睿
谭宽
胡允兆
CHENG Hongji;HUANG Yuli;HUANG Weijun;LI Meijun;TONG Huiyu;SHEN Changzao;CHEN Rui;TAN Kuan;HU Yunzhao(Department of Cardiology,Panyu District He Xian Memorial Hospital,Guangzhou,Guangdong 511400,China;Department of Cardiology,Shunde Hospital of Southern Medical University,Foshan,Guangdong 528300,China)
出处
《中国动脉硬化杂志》
CAS
2020年第12期1060-1064,共5页
Chinese Journal of Arteriosclerosis
基金
广东省佛山市自筹经费类科技计划项目(2018AB000783)
佛山市科技创新项目(医学科技创新平台)资助(FS0AA-KJ218-1301-0006,FS0AA-KJ218-1301-0010)。
关键词
急性心力衰竭
生存状况
死亡率
预测因素
预后
acute heart failure
survival condition
mortality
predictive factor
prognosis
