摘要
目的:分析近30年来慢性心力衰竭(心衰)住院患者合并肾功能不全的发生率、临床特点及治疗情况。方法:采用回顾性方法,分析慢性心力衰竭患者合并肾功能不全的发生率,以肾小球滤过率将心衰患者分为A(肾功能正常)、B(肾功能轻度受损)、C(肾功能不全)3组,以入院年代将心衰合并肾功能不全患者(C组)分为Ⅰ(1980年1月—1989年12月)、Ⅱ(1990年1月—1999年12月)、Ⅲ(2000年1月—2007年8月)3组,分析临床特点和治疗情况。结果:入选2459例,其中合并肾功能不全者714例(29.0%)。与A组、B组患者相比,C组患者年龄较大,合并高血压病、糖尿病、贫血、低钠血症的比例较高,左心室射血分数较低,且住院时间较长、住院病死率较高,利尿剂、洋地黄应用比例较高,而血管紧张素转化酶抑制剂(ACEI)、β-受体阻滞剂使用比例较低(均P<0.01)。结论:慢性心力衰竭患者合并肾功能不全的发生率较高,年龄较大、心功能差、住院时间较长、住院病死率较高,治疗仍以硝酸酯、利尿剂、洋地黄为主,而ACEI、β-受体阻滞剂的应用比例较低,与指南差距较大。
Objective： To analyze the incidence, clinical feature and drug treatment of hospitalized chronic heart failure （CHF） patients with renal dysfunction for recent 30 years. Methods： Applying retrospective method to describe the incidence of hospitalized CHF patients with renal dysfunction. According to glomerular filtration rate and eras, all the CHF patients and CHF with renal dysfunction patients were divide into three groups which included group A with normal renal function, group B with mild renal function damage, and group C with renal dysfunction. According to the hospitalized time, all patients were divided into group Ⅰ （1980.01--1989.12）, group Ⅱ （1990.01--1999. 12）, and group Ⅲ （2000.01--2007.08）, and the clinical feature and drug treatment were analyzed. Results： In all 2 459 complete data cases, 714 （29.0%） cases had renal dysfunction. Compared with group A and B, the patients in group C were elder, the proportion of hypertension, diabetes, aneamia, hyponatremia and cardic function NYHA Ⅳ was higher, left ventricular ejection fraction was lower, hospital stay was longer, and in-hospital case-fatality rate was higher. The usage of diuretics and digitalis was higher, but the usage of an- giotensin converting enzyme inhibitor （ACEI） and 13-blocker was lower （P 〈 0.01）. Conclusion： The incidence of renal dysfunction was higher in CHF patients. The age was elder, cardiac function was worse, hospital stay was longer, and in-hospital case-fatality rate was higher in the patients with renal dysfunction. The usage of diuretics and digitalis was higher, while the usage of ACEI and β- blocker was lower than the guidlines.
出处
《天津医药》
CAS
北大核心
2009年第4期261-265,共5页
Tianjin Medical Journal
基金
吴阶平医学基金会资助项目(项目编号:2003-58-A)
关键词
心力衰竭
充血性
肾功能衰竭
药物疗法
回顾性研究
heart failure, congestive kidney failure drug therapy retrospective studies
