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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

• 临床医学 • 上一篇    下一篇

无选择性152例成年慢性心力衰竭患者再入院的危险因素

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   

  1. 1. 山东大学齐鲁医院老年医学科, 山东 济南 250012;2. 山东省心血管蛋白质组学重点实验室, 山东 济南 250012;3. 山东大学齐鲁医院心血管内科, 山东 济南 250012;4. 教育部与国家卫健委心血管重构与功能研究重点实验室, 山东 济南 250012;5. 东营市人民医院心血管内科, 山东 东营 257100
  • 发布日期:2021-04-30
  • 通讯作者: 王志浩. E-mail:wangzhhaosdu@126.com
  • 基金资助:
    山东省重点研发计划(2017GSF18156;2019GSF108041)

Readmission prediction of 152 non-selective adult patients with chronic heart failure

LAN Hongtao1,2, JIA Xu3,4, TONG Zhoujie3,4, ZHENG Man5, HU Boang3,4, ZHONG Ming3,4, ZHANG Wei3,4, WANG Zhihao1,2   

  1. 1. Department of Geriatric Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Shandong Key Laboratory of Cardiovascular Proteomics, Jinan 250012, Shandong, China;
    3. Department of Cardiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    4. Key Laboratory of Cardiovascular Remodeling and Function, Ministry of Education and National Health Commission, Jinan 250012, Shandong, China;
    5. Department of Cardiology, Dongying People s Hospital, Dongying 257100, Shandong, China
  • Published:2021-04-30

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。

关键词: 慢性心力衰竭, 再入院率, 疾病复发, 再入院时间间隔

Abstract: Objective To explore the influencing factors of readmission of patients with chronic heart failure(CHF). Methods A total of 152 CHF cases treated during May 2016 and Dec. 2018 were enrolled in this retrospective study, including 107 males and 45 females, age 26 to 93 years, average 70.95±14.08 years. Statistical analyses of clinical indicators, laboratory tests and drug use were performed with SPSS 20.0 software. CHF patients were divided into recurrence and non-recurrence groups for bivariate Logistic regression analysis. The readmission interval of patients with multiple admissions was analyzed with linear regression analysis. Results The recurrence rate of CHF was 58.6%. Compared with the non-recurrence group, the recurrence group tended to have a history of coronary heart disease(CHD), abnormal NT-proBNP and creatinine level, and no consumption of angiotensin converting enzyme inhibitor(ACEI)drugs, and the differences were statistically significant(P<0.05). Bivariate Logistic regression analysis revealed history of CHD(OR=3.728, 95%CI=1.902-7.308), use of digoxin(OR=1.320, 95%CI=1.034-1.686)and abnormal NT-proBNP(OR=4.854, 95%CI=2.010-11.723)were risk factors of recurrence, while increased diastolic blood pressure(DBP)(OR=0.982,95%CI=0.971-0.993)was a protective factor. Linear regression analysis showed age(β=-1.501, P=0.001)and history of diabetes(β=-0.810, P=0.036)were negatively correlated with the interval of readmission; gender(β=1.231, P=0.001), heart rate(HR, β=1.546, P=0.001), and taking of aspirin(β=0.477, P=0.001)were associated with prolonged interval of readmission. Conclusion There is a nonstandard administration of CHF patients and the recurrence rate is high. NT-proBNP, heart rate and diastolic blood pressure should be closely monitored to reduce the recurrence rate of CHF.

Key words: Chronic heart failure, Readmission rate, Recurrence, Interval of readmission

中图分类号: 

  • R541.6
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