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目的分析心力衰竭患者出院后预后状况及影响因素,为早期临床干预提供依据。方法采用前瞻性病例对照研究方法,统计2013年6月至2015年6月,首都医科大学附属北京地坛医院348例冠心病心力衰竭患者终点事件发生率(出院后1年内死亡或再住院),并据此分为预后不良与预后良好组。采用SPSS 17.0软件,计量资料采用独立样本t检验,计数资料采用χ~2检验,多因素分析采用非条件logistic回归分析,P<0.05为差异有统计学意义。结果 348例患者出院后1年内因心力衰竭再住院率为16.95%(59/348),死亡率为12.07%(42/348),因心力衰竭再住院率或死亡率为29.02%(101/348)。多因素分析显示性别(95%CI:0.145~0.875,P=0.025)、年龄(95%CI:0.587~1.301,P=0.030)、体质量指数(95%CI:0.458~1.253,P=0.004)、血Na+(95%CI:0.812~1.245,P=0.041)、血红蛋白浓度(Hb)(95%CI:0.925~1.027,P=0.032)、LgNT-ProBNP(95%CI:1.201~7.258,P=0.025)均为影响心力衰竭患者出院后1年内预后的独立危险因素。结论心力衰竭患者出院后1年内死亡或再住院仍然较高,年龄、性别、贫血等是主要影响因素。
Objective To analyze the prognosis and influencing factors of patients with heart failure after discharge and provide the basis for early clinical intervention. Methods A prospective case-control study was conducted. The incidence of end-point events in 348 patients with heart failure and heart failure (death or rehospitalization within 1 year after discharge) in 348 patients who were admitted to Beijing Ditan Hospital, Capital Medical University from June 2013 to June 2015 were analyzed. According to this is divided into poor prognosis and good prognosis group. Using SPSS 17.0 software, measurement data using independent samples t test, count data using χ ~ 2 test, multivariate analysis using non-conditional logistic regression analysis, P <0.05 for the difference was statistically significant. Results The 348 hospitalizations for heart failure within one year after hospital discharge were 16.95% (59/348) and 12.07% (42/348) respectively. The rate of rehospitalization or death due to heart failure was 29.02% (101/348 ). Multivariate analysis showed that body mass index (95% CI: 0.145-0.875, P = 0.025), age (95% CI 0.587-1.301, P = 0.030) (95% CI: 0.812-1.245, P = 0.041), hemoglobin concentration (95% CI: 0.925-1.227, P = 0.032), LgNT- ProBNP (95% CI: 1.201-7.258, P = 0.025) were independent risk factors affecting the prognosis of patients with heart failure within 1 year after discharge. Conclusions The death or rehospitalization of patients with heart failure within one year after discharge is still high, with age, gender and anemia being the main influencing factors.