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| Analysis of recent prognosis of elderly patients with acute decompensated heart failure and its influencecing factors |
| WANG Yin ZHANG Bin▲ |
| First Department of Cardiovascular, Traditional Chinese Medicine Hospital of Baoji City, Shaaxi Province, Baoji 721000, China |
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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 groups (P > 0.05); the age, BMI, NYHA classification, serum creatinine, GFR, LVEF, NT-proBNP, cTnI and level of NSE of patients in the two groups had statistically significant differences (P < 0.05). Logistic regression analysis showed that the multiple factors, age≥70 years, BMI>35 kg/m2, NYHA class Ⅳ, LVEF <50%, NT-proBNP>3600 pmol/L were the influence factors of major adverse cardiovascular events in elderly patients with acute decompensated heart failure (OR = 2.198, 1.647, 3.887, 3.542, 2.239, P < 0.05). Conclusion Age, obesity, NYHA classification Ⅳ, lower LVEF and higher level of NT-proBNP is the influencecing factors of the recent prognosis of elderly patients with acute decompensated heart failure,and NYHA classification, LVEF has obvious correlation with the NT-proBNP,so the clinical should pay attention to these patients who with higher NYHA classification and lower LVEF.
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[1] 贺文奇，楚英杰.老年急性失代偿心力衰竭患者临床特点及近期预后危险因素分析[J].中华老年医学杂志，2016， 35（1）：8-12.
[2] 赵春梅，周秋根，侯凡凡.新发急性肾损伤和慢性肾脏病基础上的急性肾损伤对急性失代偿性心力衰竭患者预后的影响[C]//中华医学会肾脏病学分会2011学术年会，2011.
[3] 黄燕，邹长虹，张荣成，等.住院心力衰竭患者入院时低钠血症的发生率及其对预后的影响[J].中华心血管病杂志，2015，43（10）：868-873.
[4] 李小宇，杨淑芳，秦俭，等.老年急性心力衰竭住院患者近期预后的影响因素分析[J].中华老年多器官疾病杂志，2013，12（12）：908-911.
[5] 王智明.急性失代偿性心衰患者NTpro-BNP/BNP与NTpro-BNP、BNP对患者预后的预测价值比较[J].中国医药导报，2016，13（2）：16-19.
[6] 马国栋，沈爱东.血浆NT-proBNP对高龄收缩性心力衰竭急性失代偿期患者预后判断价值[J].中国循证心血管医学杂志，2015，30（1）：113-115.
[7] 中华医学会心血管病学分会，中华心血管病杂志编辑委员会.2014版中国心力衰竭诊断和治疗指南[J].中华心血管病杂志，2014，42 （2）：98-122．
[8] 杨小兵.尿血管紧张素原（AGT）在急性失代偿性心力衰竭病人AKI中的预测作用和预后价值[D].广州：南方医科大学，2013.
[9] 赵秀娟，朱凤雪，李纾，等.非心脏手术后重症患者主要不良心脏事件的危险因素分析[J].中华普通外科杂志，2015，30（11）：875-878.
[10] 傅炜钢．左西孟旦对老年急性失代偿性心力衰竭患者血流动力学的影响[J]．中国老年学杂志，2014，34（19）：5376-5378．
[11] 朱黎．慢性心力衰竭患者血浆S100B蛋白水平的检测与临床意义[J]．医学与哲学，2015，36（9B）：47-49．
[12] 刘彤，宋德利，刘巍等.急性失代偿性心力衰竭患者低钠血症的处理[J].中华心血管病杂志，2016，44（6）：473-476.
[13] 蒋宇，俞锐敏.急性失代偿性心力衰竭治疗进展[J].岭南急诊医学杂志，2009，14（6）：501-503.
[14] 贺文艳.红细胞分布宽度与Nt-proBNP对急性心力衰竭短期预后的预测价值比较[D].重庆：重庆医科大学，2014.
[15] Fonarow GC，Adams Jr KF，Abraham WT，等.急性失代偿性心力衰竭院内死亡率的危险分层：分类回归树分析[J].世界核心医学期刊文摘：心脏病学分册，2005，2（6）：24.
[16] 张健，王运红.2015年急性心力衰竭指南解读[J].临床内科杂志，2016，33（1）：5-7.
[17] 王国干，林乐语.北京地区急诊心力衰竭患者三年随访预后及危险因素的临床研究[J].中国循环杂志，2016， 31（z1）：10.
[18] Asano R，Kajimoto K，Oka T，et al. Association of New York Heart Association functional class Ⅳ symptoms at admission and clinical features with outcomes in patients hospitalized for acute heart failure syndromes [J]. Int J Cardiol，2016.pii： S0167-5273（16）：34539-34549.
[19] 赵立杰，刘铭雅，朱伟，等.血清神经元特异性烯醇化酶对急性失代偿性心力衰竭预后的预测价值[J].临床心血管病杂志，2014，30（4）：298-301.
[20] 罗慧敏，刘绍辉，何明丰，等.血浆NT-proBNP在AHF诊治及预后评估中的应用价值[J].中国医药科学，2016， 6（17）：174-176.
[21] 阮中宝，朱莉，殷屹岗，等.慢性心力衰竭患者血浆N末端脑钠肽前体和血清胱抑素C的水平及意义[J].中华全科医师杂志，2011，10（5）：311-314. |
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