摘要
目的探讨血脂水平对重症心力衰竭患者预后的影响。方法回顾性分析149例重症心力衰竭患者的临床资料，比较不同病因及不同NYHA心功能分级患者的血脂水平，并比较低血脂水平与非低血脂水平患者预后的差异。结果不同NYHA心功能分级患者白蛋白（ALB）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL．C）、低密度脂蛋白胆固醇（LDL-C）水平比较差异有统计学意义（P〈0．05），而三酰甘油（TG）水平比较差异无统计学意义（P〉0．05）。扩张型心肌病和风湿性心脏病患者TC、HDL-C、LDL．C水平低于冠心病合并高血压及缺血性心肌病患者，差异有统计学意义（P〈O．05）。在随访的2年中，低血脂水平患者死亡、病情加重、住院次数〉2次／年及住院时间〉1个月的比例[分别为29．0％（9／31）、25．8％（8／31）、48．4％（15／31）、61．3％（19／31）]显著高于非低血脂水平患者[分别为9．3％（11／118）、9．3％（11／118）、17．8％（21／118）、24．6％（29／118）]，差异均有统计学意义（P〈0．01或〈0．05）。结论重症心力衰竭患者NYHA心功能分级越高，血脂水平越低。低血脂水平将严重影响患者的预后。
Objective To investigate the effect of the levels of serum lipid on the prognosis of patients with severe heart failure. Methods The clinical data of 149 patients with severe heart failure was analyzed retrospectively, the levels of serum lipid were compared among different causes and different NYHA cardiac functional grading patients. And the prognosis was compared between low-serum lipid and nonlow-serum lipid patients. Results There were significant differences in the levels of total cholesterol （TC）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C）, albumin （ALB） among different NYHA cardiac functional grading （P 〈 0.05）,but there was no significant difference in triacylglycerol （TG） among different NYHA cardiac functional grading（P 〉 0.05 ）. The levels of TC, HDL-C, LDL-C in dilated cardiomyopathy and rheumatic heart disease were lower than those in coronary heart disease combined with hypertension and ischemic cardiomyopathy,there were significant differences （P 〈0.05）. Followed up for 2 years, the mortality, deteriorated frequency, hospitalization frequency more than 2 times a year and hospitalization time more than 1 month in low-serum lipid patients [29.0%（9/31 ）,25.8%（8/31 ）, 48.4% （ 15/31 ）, 61.3 % （ 19/31 ） ] were higher than those in non-low-serum lipid patients [ 9.3 % （ 11/118 ）, 9.3%（11/118）, 17.8%（21/118）,24.6%（29/118）],and there were significant differences （P 〈0.01 or 〈 0.05）. Conclusions For patients with severe heart failure,NYHA cardiac functional grading has significantly negative correlation with their serum lipid levels. Lower serum lipid levels will seriously affect the prognosis of patients.
出处
《中国医师进修杂志》
2011年第34期18-20,共3页
Chinese Journal of Postgraduates of Medicine
关键词
心力衰竭
充血性
血脂异常
心功能分级
Heart failure,congestive
Dyslipidemias
Cardiac functional grading
