吴华芹,张并璇,李雨濛,杨阳柳林,赵畅,宋庆桥

• 1:中国中医科学院广安门医院
• 2:北京市大兴区中西医结合医院

摘要(Abstract)：

目的分析慢性心力衰竭(CHF)住院患者发生心肾综合征(CRS)的临床特点及相关危险因素。方法选取147例CHF患者,根据eGFR值是否<60 mL/(min·1.73 m2)分为CHF组65例和CRS组82例,收集患者一般临床资料及化验检查指标,采用Logistic回归对CHF伴发CRS的危险因素进行单因素和多因素分析。结果两组患者在年龄、性别、心功能分级、高血压病史方面差异均有统计学意义(P <0.05或P <0.01)。CRS组患者血Hb、LVEF水平明显降低,PLT、UA、血脂、左室壁厚度明显增加,与CHF组比较差异具有显著性统计学意义(P <0.05或P <0.01)。Logistic回归显示,高龄、女性、高血压病史、入院时PLT、LDL-C、UA升高,LVEF值降低是CHF发生CRS的高危因素。结论高龄、女性、高血压病史、入院时PLT、UA、LDL-C水平升高、LVEF值降低的CHF患者容易发生CRS。

关键词(KeyWords)： 心力衰竭;心肾综合征;危险因素

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81573799)

作者(Author): 吴华芹,张并璇,李雨濛,杨阳柳林,赵畅,宋庆桥

参考文献(References)：

• [1] KingmaJG,Simard D,Rouleau JR. Renocardiac syndromes:physiopathology and treatment stratagems[J]. Can J Kidney Health Dis,2015(2):41.
• [2] Mckee PA,Castelli WP,Mcnamara PM,et al. The natural history of congestive heart failure:the Framingham study[J].New England Journal of Medicine,1971,285(26):1441-1446.
• [3] Clyde W.Yancy, Mariell Jessup. 2013 ACCF/AHA guideline for the management of heart failure:a report of the American college of cardiology Foundation/American heart association task force on practice guidelines[J]. Circulation,2013,128:e240-327.
• [4] Ronco C,Mccullough P,Anker SD,et al. Cardio-renal syndromes:report from the consensus conference of the acute dialysis quality initiative[J]. European Heart Journal,2010,31(6):703-711.
• [5] Damman K,Valente MAE,Voors AA,et al. Renal impairment, worsening renal function, and outcome in patients with heart failure:an updated meta-analysis[J]. European Heart Journal,2014,35(7):455-469.
• [6] Tasic D,Radenkovic S,Kocic G,et al. Microinflammation factors in the common diseases of the heart and kidneys[J].Disease Markers,2015,2015:470589.
• [7]山萌萌,王凤菊,庞晓,等.慢性心力衰竭合并肾功能不全相关危险因素分析[J].中国动脉硬化杂志,2017,25(6):604-609.
• [8]张迪,李斌,马淑梅.慢性心功能不全患者合并肾功能不全的高危因素分析[J].中国医科大学学报,2015,44(8):725-729.
• [9] McAlister FA,Ezekowitz J,Tonelli M,et al. Renal insumciency and heart failure:Prognostic and therapeutic implications from a prospective cohort study[J]. Circulation,2004,109(8):l004-l009.
• [10] Ankur S,Sandeep S,Michael H,et al. Managing anemia in patients with chronic heart failure:what do we know[J]. Vascular Health&Risk Management,2010,6(1):237-252.
• [11]陈东,马建新,宋成运.老年慢性心力衰竭伴发心肾综合征的临床特点及相关危险因素分析[J].内科急危重症杂志,2017,23(4):301-303.
• [12]杨阳柳林,吴华芹,胡元会,等.贫血对慢性心力衰竭患者预后影响的临床研究[J].北京中医药,2017,67(3):195-200.
• [13] Katz AM. The cardiomyopathy of overload:an unnatural growth response in the hypertrophied heart[J]. Ann Int Med,1994,121(5):363-371.
• [14] Johnson DB,Dell'Italia LJ. Cardiac hypertrophy and failure in hypertension[J]. Curr Opin Nephrol Hypertens,1996,5(2):186-191.
• [15]张明洁,李明,吕登峰,等.慢性肾脏疾病患者血栓前状态的检测结果分析[J].微循环学杂志,2011,21(4):35-36.
• [16]周安兰,王淑文. 68例肾脏病与血小板,血浆颗粒膜蛋白-140关系的研究[J].细胞与分子免疫学杂志,1997,13(2):42-43.
• [17] Kowalczyk E,Kasprzak JD,Lipiec P. Heart failure is an independent predictor of thrombus persistence in non-valvular atrial fibrillation-transesophageal echocardiography-based study[J]. Pol Arch Med Wewn,2015,125(5):358-362.
• [18]王齐国,龙训辉,徐测梁.慢性心力衰竭患者血小板PAC-1与NT-proBNP的相关性分析[J].中西医结合心脑血管病杂志,2015,13(14):1650-1652.
• [19]陈世德,陶新智.心力衰竭引起血栓前状态的机制的探讨[J].临床心血管病杂志, 2003,19(11):658-659.
• [20] Hamaguchi S,Furumoto T,Tsuchihashi-Makaya M,et al. Hyperuricemia predicts adverse outcomes in patients with heart failure[J]. Int J Cardiol,2011,151(2):143-147.
• [21]韩贤珍,刘艳丽,宋书凯.慢性心力衰竭并高尿酸患者降尿酸治疗的临床意义[J].中国分子心脏病学杂志,2015,15(3):1390-1393.
• [22]徐玮,陈卫东.高尿酸血症对肾损伤的机制研究进展[J].安徽医学,2017,38(5):665-667.
• [23]王玲,俞兴群.慢性心力衰竭住院患者Ⅱ型心肾综合征的发生及危险因素分析[J].中国中西医结合肾病杂志,2015,16(1):46-48.
• [24]杨雪卿,王显.冠心病心力衰竭病人肾功能恶化的相关危险因素分析[J].中西医结合心脑血管病杂志,2017,15(20):2521-2525.