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目的:回顾性研究低钠血症对心力衰竭住院患者预后的影响。方法:调取2014年7月-2015年11月所有在中山大学孙逸仙纪念医院住院的符合入选标准的心力衰竭患者资料,共152例,分析低钠血症的发生率及其对心衰住院患者住院天数、住院全因死亡率的影响。结果:低钠血症发生率为28/152(18.42%);低钠血症与正常血钠组在扩张型心肌病基础疾病、入院时收缩压、NYHA心功能分级、血白蛋白水平、血钠浓度、C反应蛋白、NT-pro BNP等方面均有明显差异(P﹤0.05);低钠血症组全因死亡率明显高于正常血钠组(17.86%vs2.42%,P﹤0.05)。低钠血症组患者住院天数明显长于正常血钠组(15.4天vs 9.4天,P﹤0.05);在多因素分析中,在校正其他因素影响后,低钠血症依然是住院期间全因死亡(R=1.782,95%CI:1.239-2.699,P﹤0.01)和住院天数延长(R=1.623,95%CI:1.212~2.357,P﹤0.05)的独立危险因素。结论:低钠血症是心衰患者的一种常见水电解质失衡类型。同时低钠血症可明显延长患者住院时间,增加住院期间全因死亡率。
Objective: To retrospectively study the impact of hyponatremia on the prognosis of hospitalized patients with heart failure. Methods: A total of 152 congestive heart failure patients who were hospitalized at Sun Yat-sen Memorial Hospital of Sun Yat-sen University from July 2014 to November 2015 were enrolled. A total of 152 patients were enrolled in this study. The incidence of hyponatremia and its effect on hospitalized patients with heart failure Hospitalization days, all-cause hospital mortality. Results: The incidence of hyponatremia was 28/152 (18.42%). The incidence of hyponatremia was significantly higher in patients with dilated cardiomyopathy than in normal hyponatremia group, systolic blood pressure at admission, NYHA functional class, serum albumin level, (P <0.05). All-cause mortality in hyponatremia group was significantly higher than that in normal sodium group (17.86% vs 2.42%, P <0.05) ). The hospitalization days in patients with hyponatremia were significantly longer than those in patients with normal sodium (15.4 vs 9.4 days, P <0.05). In the multivariate analysis, after adjusting for other factors, hyponatremia was still all-cause death during hospitalization (R = 1.782,95% CI: 1.239-2.699, P <0.01) and hospital stay (R = 1.623,95% CI: 1.212-2.357, P <0.05). Conclusions: Hyponatremia is a common type of water-electrolyte imbalance in patients with heart failure. At the same time hyponatremia can significantly prolong the hospitalization time and increase all-cause mortality during hospitalization.