新入血液透析患者伴发心力衰竭及其危险因素的研究-东南大学学报医学版

新入血液透析患者伴发心力衰竭及其危险因素的研究

单位：东南大学附属中大医院肾内科;

分类号：

出版年·卷·期（页码）：2009·28·第四期（292-297）

摘要：

目的:调查我院近10年来新入血液透析患者慢性心力衰竭(CHF)患病状况,并对相关因素进行分析。方法:1997年1月1日至2006年12月31日10年间,在我院确诊为终末期肾病(ESRD)并行血液透析治疗的患者252例,回顾性分析并发CHF的临床特点,多因素Logistic回归分析该组患者CHF相关危险因素。结果:症状性CHF患病率高达54.2%,32.4%的患者因药物无法控制的中重度心衰而进入血液透析;CHF患者中左室射血分数(LVEF)<50%的比例仅为14.1%,12.2%的患者左室短轴缩短率(LVFS)<25%,而E/A<1的比例高达85.3%。CHF组血清肌酐清除率(Ccr)显著高于非CHF组(P=0.038);多因素Logistic回归显示冠心病(OR2.651,CI1.108~6.342)、原发病为高血压(OR2.355,CI1.011~5.489),心脏结构功能异常包括左室高电压(OR1.894,CI1.110~3.940)、心律失常(OR2.751,CI1.456~5.196)、LVEF<50%(OR2.608,CI1.156~5.887)、舒张期左房内径(LA)增大(>3.3 cm,OR4....

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