低钠血症对慢性心力衰竭的预后价值

目的 探讨慢性心力衰竭患者低钠血症的预后价值.方法 对2007年1月至2013年1月于我院急诊内科住院治疗资料完整的786例慢性心力衰竭患者进行回顾性分析,根据入院24～48 h血清钠离子浓度最低值分为三组：A组,钠离子≥135 mmol/L;B组,钠离子120～135 mmol/L;C组,钠离子≤120 mmol/L.比较各组心功能、血清钾离子浓度、住院病死率等指标.结果 住院期间存活714例,死亡72例,存活组与死亡组平均血清钠离子浓度分别为（134.00±5.83）mmol/L和（121.00±7.15）mmol/L,差异有统计学意义（P＜0.01）,而血清钾离子浓度分别为（4.4±0.6）mmol/L和（4.3±0.8）mmol/L,差异无统计学意义（P＞0.05）.三组住院病死率分别为：A组7.8％（36/461）,B组8.0％（23/289）,C组36.1％（13/36）,C组病死率明显高于A组和B组,差异有统计学意义（P＜0.01）;A组与B组比较差异无统计学意义（P＞0.05）.结论 低钠血症是慢性心力衰竭患者预后不良的重要危险因素.

The prognostic value of hyponatremia in patients with chronic heart failure

Objective To evaluate the prognostic significance of hyponatremia in patients with chronic heart failure. Methods 786 patients with chronic heart failure were studied in our departmengt from January 2007 to January 2013. The patients were divided into three groups according to serum sodium con- centration 24 hous to 48 hours after admission： Group A Na＋〉 135mmol/L,Group B Na＋ 120-135 mmol/L. Group C Na＋≤ 120 mmol/L. The data of heart function,serum kalium concentration and inhospital mortality were analyzed retrospectively. Results 714 cases were recovered and 72 cases died during treatment. Serum sodium concentration in recovered group （134.00±5.83）mmol/L was significantly higher than that of the died group （121.00±7.15）mmol/L （P〈0.01） with no significant difference in serum kalium concentration （P〉0.05）. The inhospital mortality of each group： group A 7.8%（36/461）, group B 8.0%（23/289）, groupC 36.1%（13/36）. Inhospital mortality of. groupC was significantly higher than groupA and group B（P〈 0.01 ）;there was no difference between group A and group B （P〉0.05）.Conclusion Hyponatremia is one of the important risk factors of bad prognosis for chronic heart failure.