慢性肾脏病患者发生心衰的危险因素分析

目的探讨慢性肾脏病（CKD）患者发生心衰的危险因素。方法将366例CKD患者按2002年K/DOQI慢性肾脏病的分期标准分为5期,再按是否发生心衰分为2组,比较两组患者年龄、既往病史、吸烟史、心电图T波改变、血红蛋白（Hb）、C反应蛋白（CRP）、血脂、血压等方面的变化以及住院期间两组患者的病死率。结果发生心衰组的年龄升高,有既往高血压、糖尿病、冠心病、吸烟史者、心电图T波改变均比未发生心衰组明显增多（P〈0.05）;心衰组C反应蛋白（CRP）、高密度脂蛋白胆固醇（HDL-L）、舒张压（DBP）均比未心衰组明显升高（P〈0.01）,而Hb、低密度脂蛋白胆固醇（LDL-L）则比未心衰组明显降低（P〈0.01）结论患者年龄升高、既往有心血管病史、吸烟、CRP水平、Hb水平是CKD患者发生心衰的独立危险因素,针对性地干预这些危险因素,有可能降低心衰的发生率和病死率,改善CKD患者的预后。

Risk factors analysed for heart failure in patients with chronic kidney disease

Objective To investigate the related risk factors of heart failure in patients with chronic kidney disease(CKD).Methods Three hundred and sixty-six cases with CKD were divided into group with heart failure and group without heart failure. The age, past medical history, history of smoking,changes of T wave,Hb, CRP and case fatality of the two groups were compared. Results The level of age of group with heart failure was elder than group without heart failure (P<0.05).History of hypertension,diabetes,history of coronary heart disease,history of CVD ,smoking and changes of T wave, were increased in group with heart failure (P<0. 05).The level of CRP, HDL-C and DBP of group with heart failure were higher than those of group without heart failure (P<0.01). The level of Hb and LDL-C of group with heart failure were lower than those of group without heart failure (P<0.01).The case fatality of group with heart failure. was higher than group without heart failure (P<0.01); The independent risk factors for cardiovascular events were age, history of coronary heart disease, level of CRP and Hb, and smoking. Conclusion There are many independent risk factors of heart failure in patients with CKD. Intervention these risk factors might improve the prognosis of heart failure in patients with CKD and decrease the incidence and fatality.