非透析慢性肾衰竭患者发生心功能不全危险因素分析

目的 探讨非透析慢性肾衰竭（CRF）患者发生心功能不全（HF）的危险因素，为防治心功能不全的发生提供诊疗思路。方法 回顾性分析武汉大学人民医院2015年1月~2017年1月住院且临床资料完整的慢性肾衰竭（CKD4~5期）患者289例，依据是否发生心功能不全分为两组：肾衰竭合并心力衰竭组（CRS组）和单纯肾衰竭组（对照组）。收集患者一般资料及相关辅助检查资料及实验室检验指标，采用多因素Logistic回归分析慢性肾衰竭患者发生心功能不全的相关高危因素。结果 单因素分析显示，糖尿病、血压、贫血程度、心肌损伤、白蛋白、肾功能、心肌肥厚、心包积液程度在两组间差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，糖尿病（OR=2.308，P=0.002）、高血压（OR=2.464，P=0.000）、肌酶升高（OR=3.065，P=0.000）、低白蛋白（OR=0.845，P=0.000）、低血钙（OR=0.062，P=0.000）、高血磷（OR=2.868，P=0.004）是发生心功能不全的危险因素。结论 糖尿病、高血压、心肌损伤、低白蛋白、钙磷失衡是慢性肾衰竭患者发生心功能不全的危险因素。重视这些因素的把控对防治心功能不全具有重要意义。

Analysis of Risk Factors for Heart Failure in Patients with Non-dialysis Chronic Renal Failure

Objective To investigate the risk factors of heart failure in patients with non-dialysis chronic renal failure,to provide a reference for the prevention and treatment of heart failure. Methods A total of 289 patients in Renmin Hospital of Wuhan University from January 2015 to January 2017 were enrolled in this retrospective study.They were divided into two groups according to the occurrence of heart failure.General information, relevant auxili-ary examination and laboratory tests were collected to analyze.Multivariate Logistic regression was used to analyze the risk factors of heart failure in patients with chronic renal failure. Results Univa-riate analysis showed that diabetes,blood pressure, anemia, myocardial damage, albumin, renal function, myocardial hypertrophy, pericardial effusion in the two groups were statistically significant(P<0.05).Logistic regression analysis showed that diabetes (OR=2.308,P=0.002), hypertension (OR=2.464,P=0.000), elevated creatine kinase (OR=3.065,P=0.000), hypoalbuminaemia (OR=0.845,P=0.000), hypocalcemia (OR=0.062,P=0.000), hyperphosphatemia (OR=2.868,P=0.000) were independently associated with heart failure in patients of chronic renal failure. Conclusion Diabetes mellitus, hypertension, myocardial in-jury, low albumin, imbalance of calcium-phosphorus metabolism are risk factors for heart failure.Paying attention to these factors is of great significance to the prevention and treatment of heart failure.