山东大学学报 (医学版) ›› 2021, Vol. 59 ›› Issue (4): 63-69.doi: 10.6040/j.issn.1671-7554.0.2020.1439
兰洪涛1,2,贾旭3,4,童洲杰3,4,郑曼5,胡伯昂3,4,钟明3,4,张薇3,4,王志浩1,2
LAN Hongtao1,2, JIA Xu3,4, TONG Zhoujie3,4, ZHENG Man5, HU Boang3,4, ZHONG Ming3,4, ZHANG Wei3,4, WANG Zhihao1,2
摘要: 目的 明确慢性心力衰竭患者中影响再入院的因素,提高对慢性心力衰竭的认识及防治水平。 方法 回顾性分析山东省东营市2016年3月至2018年12月慢性心力衰竭患者152例,其中男107例,女45例, 26~93岁,平均(70.95±14.08)岁,基于SPSS 20.0对患者临床指标、实验室检查、药物使用情况进行统计分析,根据心力衰竭分为慢性心力衰竭复发组和慢性心力衰竭无复发组,行二元Logistic回归分析,将多次入院患者的再入院时间间隔进行线性回归分析。 结果 慢性心力衰竭患者复发率为58.6%,与慢性心力衰竭无复发组相比,慢性心力衰竭复发组具有冠心病病史、不服用血管紧张素转化酶抑制剂(ACEI)类药物、氨基末端脑钠肽前体(NT-proBNP)异常、肌酐含量异常,两组差异有统计学意义(P<0.05);二元Logistic回归分析显示,冠心病病史(OR=3.728,95%CI=1.902~7.308)、使用地高辛(OR=1.320,95%CI=1.034~1.686)和NT-proBNP异常(OR=4.854,95%CI=2.010~11.723)是导致慢性心力衰竭患者疾病复发的危险因素;舒张压升高(OR=0.982,95%CI=0.971~0.993)是导致慢性心力衰竭患者疾病未复发的保护因素;线性回归分析结果显示,年龄增加(β=-1.501,P=0.001)和糖尿病病史(β=-0.810,P=0.036)均与慢性心力衰竭患者再入院时间间隔呈负相关;女性(β=1.231,P=0.001)、心率快(β=1.546,P=0.001)和使用阿司匹林(β=0.477,P=0.0001)均可延长慢性心力衰竭患者再入院的时间间隔。 结论 临床对慢性心力衰竭患者的疾病管理不规范,心力衰竭复发率较高。对NT-proBNP、心率、舒张压等临床指标的异常情况加以重视防范,从而减少慢性心力衰竭患者再入院的发生。
中图分类号:
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