摘要
目的探讨血清肾功能指标与尿毒症合并心力衰竭患者的相关性及预后预测价值。方法选取2020年1月—2023年1月兰州市第一人民医院收治的80例尿毒症合并心力衰竭患者作为研究对象,将所有患者应用Killip分级进行分组,其中Ⅱ级组22例,Ⅲ级组38例,Ⅳ级组20例,并选取同期兰州市第一人民医院治疗的40例单纯尿毒症患者作为对照组。比较四组患者血清肾功能相关指标表达水平,并分析血清肾功能指标与尿毒症合并心力衰竭的相关性。随后将80例尿毒症合并心力衰竭患者中院内病死者分为病死组(20例),将其余患者分为存活组(60例),对比两组患者临床一般情况与血清肾功能指标表达水平,并应用Logistic回归分析分析血清肾功能指标对尿毒症合并心力衰竭的预后预测价值。结果四组患者血肌酐(SCr)、尿素氮(BUN)、胱抑素C(CysC)、尿酸(UA)相关血清肾功能指标水平比较,Ⅳ级组患者明显高于Ⅲ级组、Ⅱ级组和对照组患者,差异有统计学意义(P<0.05);Spearman相关分析结果显示:SCr、BUN、CysC、UA相关血清肾功能指标与尿毒症合并心力衰竭呈正相关,差异有统计学意义(P<0.05)。存活组与病死组患者性别、年龄、BMI、合并糖尿病、高血压、高脂血症、心功能衰竭诱因、BUN比较,差异无统计学意义(P>0.05);存活组合并陈旧性心肌梗死占比及左心室射血分数、SCr、CysC、UA水平低于病死组,差异有统计学意义(P<0.05)。Logistic回归分析结果表明:SCr(OR=2.546,95%CI:1.364~3.475)、CysC(OR=2.774,95%CI:1.876~4.010)、UA(OR=0.326,95%CI:0.251~0.765)为尿毒症合并心力衰竭预后的独立预测指标,差异有统计学意义(P<0.05)。结论血清肾功能指标与尿毒症合并心力衰竭的严重程度具有明显相关性,且SCr、CysC、UA相关肾功能指标表达水平越高可能预示患者预后情况不良。
Objective To explore the correlation between serum renal function index and uremia complicated with heart failure and its prognostic value.Methods 80 patients with uremia complicated with heart failure admitted to Lanzhou First People's Hospital from January 2020 to January 2023 were selected as the study subjects.All patients were divided into groups according to Killip classifi cation,including 22 patients with gradeⅡ,38 patients with gradeⅢ,and 20 patients with gradeⅣ,and 40 patients with simple uremia treated in our hospital during the same period were selected as the control group.The expression levels of serum renal function related indices in the four groups were compared,and the correlation between serum renal function indicators and uremia complicated with heart failure was analyzed.Subsequently,80 patients with uremia complicated with heart failure were divided into death group(n=20)and the rest into survival group(n=60).The clinical general situation and the expression level of serum renal function indicators were compared between the two groups,and the prognostic value of serum renal function indices for uremia complicated with heart failure was analyzed by logistic regression analysis.Results The levels of SCR,BUN,CysC,UA and other related indices of renal function in the four groups were signifi cantly higher in patients with gradeⅣthan those in patients with gradeⅠ,Ⅱand control group(P<0.05);Spearman correlation analysis showed that there was a positive correlation between serum renal function indexes of SCR,BUN,CysC,UA and uremia complicated with heart failure(P<0.05);there was no significant difference in sex,age,BMI,diabetes,hypertension,hyperlipidemia,inducement of heart failure,BUN between the survival group and the death group(P>0.05),but there were signifi cant diff erences between the survival group and the death group in old myocardial infarction,left ventricular ejection fraction,SCR,CysC,UA levels(P<0.05).The results of logistic regression analysis showed that SCR(OR=2.546,95
作者
陆敬雁
LU Jing-yan(Nephrology Department,Lanzhou First People's Hospital,Lanzhou Gansu 730000,China)
出处
《中华养生保健》
2023年第20期178-181,共4页
CHINESE HEALTH CARE
关键词
肾功能
尿毒症
心力衰竭
相关性
预后预测
左心室射血分数
renal function
uremia
heart failure
relevance
prognosis prediction
left ventricular ejection fraction
