天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (10): 1159-1162.doi: 10.11958/j.issn.0253-9896.2015.10.020

• 专题研究心血管疾病 • 上一篇    下一篇

低钠血症与慢性心力衰竭的相关性及预后分析

  

  1. 中国医科大学附属盛京医院心内科(邮编 110022)
  • 收稿日期:2014-12-17 修回日期:2015-05-07 出版日期:2015-10-15 发布日期:2015-10-22

Correlation of chronic heart failure with hyponatremia and its prognostic analysis

  1. Shengjing Hospital of China Medical University, Shenyang, Liaoning 110022, China
  • Received:2014-12-17 Revised:2015-05-07 Published:2015-10-15 Online:2015-10-22

PDF (PC)

4022

摘要：

摘要： 目的 分析低钠血症与慢性心力衰竭 （CHF） 的相关性及预后的关系。方法 CHF 住院患者 （CHF 组） 507
例及同期非心衰患者（非心衰组） 212 例， 考察 2 组一般资料情况； 将差异有统计学意义的指标为自变量， 通过多元
Logistic 分析血钠与 CHF 的关系； 随访结果分析血钠与 CHF 患者病死率和再入院率的关系， 并进一步分析血钠与脑
钠肽（BNP）、 左射血分数（LVEF）保留心衰（LVEF≥0.45， HFpEF）和 LVEF 减低心衰（LVEF<0.45， HFrEF）预后的关
系。结果 2 组比较， 性别、 吸烟史等差异无统计学意义（P＞0.05）， 年龄、 血红蛋白、 血钠等差异有统计学意义（P＜
0.05）； 血钠是 CHF 的保护因素。低钠血症组 （Na+<135 mmol/L） BNP 浓度高于非低血钠组 (P＜0.05)； LVEF 差异无统
计学意义。CHF 患者中低钠血症组病死率高于非低血钠组（P＜0.05）， 而再入院率差异无统计学意义（P＞0.05），
HFpEF 患者中低钠血症组和非低血钠组病死率及再入院率差异均有统计学意义 （P＜0.05）。结论 血钠是 CHF 的
保护因素，HFpEF 合并低钠血症者远期更易死亡及再入院。

关键词: 低钠血症, 每搏输出量, 预后, Logistic 模型, 危险因素, 心力衰竭, 慢性

Abstract: Abstrsct：Objective To analyze the correlation of hyponatremia with chronic heart failure (CHF) and the prognostic
analysis of CHF. Methods Patients with CHF (n=507) and healthy adult (n=212) were included in this study. The general
data of the two groups were analysed. The index which was statistically significant was indicated as independent variables.
Multivariate logistic analysis was used to analysis the correlation between serum sodium and CHF. The relationship between
serum sodium and the prognosis of CHF include mortality and rate of readmission were included in follow-up study. The
prognostic correlation of serum sodium with BNP (brain natriuretic peptide), heart failure with preserved ejection fraction
(HFpEF, LVEF≥0.45) and heart failure with reduced ejection fraction (HFrEF, LVEF<0.45) were all analyzed. Results In⁃
dicators such as sex, smoking history showed no statistical significance between two groups (P > 0.05) while other indicators
like age, hemoglobin, serum sodium presents statistical significance (P < 0.05). Serum sodium is the protective factor for
CHF. Brain natriuretic peptide (BNP) concentration in hyponatremia group is significantly higher than that in normal serum
sodium group (P＜0.05). HFpEF and HFrEF were of no significant difference in these two groups. For patients with CHF, the
mortality in hyponatremia group is significantly higher than that in normal serum sodium group (P＜0.05), but readmission
rates were not significantly different (P＞0.05); While for patients with HFpEF, the mortality and the readmission rates were
both significantly different (P＜0.05). Conclusion Serum sodium is the protective factor in CHF, the patients with hypona⁃
tremia have higher readmission rate and death rate in HFpEF background.

Key words: hyponatremia, stroke volume , prognosis, Logistic models, risk factors, heart failure, chronic