急性失代偿期心力衰竭老年患者近期预后情况及影响因素.docVIP

急性失代偿期心力衰竭老年患者近期预后情况及影响因素 　　[摘要] 目的 分析急性失代??期心力衰竭老年患者的近期预后情况及其影响因素。 方法 回顾性分析2014年1月～2016年12月宝鸡市中医医院收治的急性失代偿心力衰竭的老年（≥60岁）患者135例的临床资料。根据近期预后情况将患者分为两组，未发生不良心血管事件的对照组及发生不良心血管事件的观察组。比较两组患者的一般临床资料，采用多因素Logistic回归分析急性失代偿期心力衰竭患者发生不良心血管事件的危险因素。 结果 135例患者中，65例（48.15%）发生了不良心血管事件，70例（51.85%）患者未发生不良心血管事件。两组患者的性别、血压、病因及肌酸激酶同工酶、血尿素氮（BUN）水平差异无统计学意义（P 0.05），而年龄、体重指数（BMI）、NYHA分级、血肌酐（Scr）、肾小球滤过率（GFR）、左室射血分数（LVEF）、脑钠肽前体（NT-proBNP）、肌钙蛋白I（cTnI）及神经元特异性烯醇化酶（NSE）水平差异有统计学意义（P 35 kg/m2、LVEF3600 pmol/L是老年急性失代偿心力衰竭患者合并不良心脏事件的危险因素（OR = 2.198、1.647、3.887、3.542、2.239，P 0.05），NT-proBNP与NYHA分级呈正相关（r = 0.546，P 0.05），而与LVEF呈负相关（r = -0.423，P 0.05）。 结论 高龄、肥胖、NYHA分级Ⅳ、低LVEF及高NT-proBNP水平是老年急性失代偿心力衰竭患者预后的影响因素，且NYHA分级、LVEF与NT-proBNP有明显的相关性，因此对于高NYHA分级、低LVEF的患者，应予以高度重视。 　　[关键词] 老年；急性失代偿；心力衰竭；预后；不良心脏事件；影响因素 　　[中图分类号] R541.6 [文献标识码] A [文章编号] 1673-7210（2017）05（b）-0052-04 　　[Abstract] Objective To analyze the recent prognosis of patients with acute decompensated heart failure and its influencecing factors. Methods From January 2014 to December 2016， in Traditional Chinese Medicine Hospital of Baoji City， the clinical data of elderly 135 patients （≥ 60 years） with acute decompensated heart failure were retrospectively analyzed， they were divided into two groups according to the prognosis： patients without adverse event were as the control group and patients with adverse event were as the observation group. The clinical data of patients in the two groups were compared； the influencing factors of prognosis were analyzed by multi-factor Logistic regression analysis； the Spearman rank correlation coefficient analysis was used to analyzed the correlation between the risk factors of major adverse cardiovascular events and level of NT-proBNP. Results There were 65 patients （48.15%） with adverse event and 70 patients （51.85%） without adverse event among 135 patients. There was no statistically significant difference in the sex， blood pressure， pathogenesis， CK-MB and pathogenesis of patients between the two group