[1]祖克拉·吐尔洪,印婷婷,努尔孜叶·阿布里克木.血清白蛋白水平对慢性心力衰竭心脏再同步化治疗患者预后的预测价值[J].医学信息,2021,34(15):89-91.[doi:10.3969/j.issn.1006-1959.2021.15.023]
 Zukra·Turhong,YIN Ting-ting,Nurziye·Abrikmu.Predictive Value of Serum Albumin Level in the Prognosis of Patients with Chronic Heart Failure and Cardiac Resynchronization Therapy[J].Medical Information,2021,34(15):89-91.[doi:10.3969/j.issn.1006-1959.2021.15.023]
点击复制

血清白蛋白水平对慢性心力衰竭心脏再同步化治疗患者预后的预测价值()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年15期
页码:
89-91
栏目:
论著
出版日期:
2021-08-01

文章信息/Info

Title:
Predictive Value of Serum Albumin Level in the Prognosis of Patients with Chronic Heart Failure and Cardiac Resynchronization Therapy
文章编号:
1006-1959(2021)15-0089-03
作者:
祖克拉·吐尔洪印婷婷努尔孜叶·阿布里克木
(新疆医科大学第一附属医院心脏起搏电生理科1,肾病科2,新疆 乌鲁木齐 830000)
Author(s):
Zukra·TurhongYIN Ting-tingNurziye·Abrikmu
(Department of Cardiac Pacing and Electrophysiology1,Department of Nephrology2,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang,China)
关键词:
血清白蛋白慢性心力衰竭心脏再同步化治疗全因死亡风险
Keywords:
Serum albuminChronic heart failureCardiac resynchronization therapyRisk of all-cause death
分类号:
R541.6
DOI:
10.3969/j.issn.1006-1959.2021.15.023
文献标志码:
A
摘要:
目的 探讨血清白蛋白水平对慢性心力衰竭心脏再同步化治疗预后的预测价值。方法 收集2012年2月~2016年12月在我院心脏中心首次行CRT植入术的合入选标准的189例患者,根据入院时患者血清白蛋白检测结果分为白蛋白正常组和低白蛋白组,比较两组一般资料,并采用单因素和多因素Cox比例风险回归模型分析血清白蛋白水平对心脏再同步化治疗患者全因死亡以及心力衰竭再入院的风险评估作用,另采用Kaplan-Meier生存分析两组患者累计无终点事件的生存率。结果 189例慢性心力衰竭接受心脏再同步化治疗患者中白蛋白正常组102例,低蛋白组87例。两组年龄、性别、体重指数、冠心病、高血压、高脂血症、心房颤动、NYHA分级、左心室射血分数、BNP以及肌酐比较,差异均无统计学意义(P>0.05);低蛋白组心脏再同步化治疗术后随访1年、2年、3年总生存率、心力衰竭再入院率低于白蛋白正常组,差异有统计学意义(P<0.05);Cox分析显示,血清白蛋白每下降1 g/L,心脏再同步化治疗患者全因死亡风险增加54.4%(HR=1.544,95%CI:1.156~3.768,P=0.014),而因心力衰竭再入院的风险增加118.9%(HR=2.189,95%CI:1.393~4.459,P=0.027)。结论 血清白蛋白水平较低是慢性心力衰竭患者心脏再同步化治疗不良临床预后的独立危险因素,可增加术后3年内全因死亡以及心衰再入院风险,术前血清白蛋白水平对于评估心脏再同步化治疗术后死亡风险具有重要意义。
Abstract:
Objective To explore the predictive value of serum albumin level in the prognosis of chronic heart failure cardiac resynchronization therapy.Methods 189 patients who underwent CRT implantation for the first time in the heart center of our hospital from February 2012 to December 2016 were collected.According to the results of serum albumin test at the time of admission, patients were divided into normal albumin group and low albumin group.The general data of the two groups were compared, and univariate and multivariate Cox proportional hazard regression models were used to analyze the effect of serum albumin levels on the risk assessment of all-cause death and heart failure readmission in patients undergoing cardiac resynchronization therapy.In addition, Kaplan-Meier survival was used to analyze the cumulative survival rate of the two groups of patients without end-point events.Results Among the 189 patients with chronic heart failure who received cardiac resynchronization therapy, there were 102 cases in the normal albumin group and 87 cases in the low protein group.There was no significant difference in age, gender, body mass index, coronary heart disease, hypertension, hyperlipidemia, atrial fibrillation, NYHA classification, left ventricular ejection fraction, BNP and creatinine between the two groups (P>0.05);The 1-year, 2-year, and 3-year overall survival rate and re-admission rate of heart failure in the low-protein group after cardiac resynchronization therapy were lower than those in the normal albumin group,the difference was statistically significant (P<0.05);Cox analysis showed that for every 1 g/L decrease in serum albumin, the risk of all-cause death in patients undergoing cardiac resynchronization treatment increased by 54.4% (HR=1.544, 95% CI: 1.156-3.768,P=0.014).The risk of readmission due to heart failure increased by 118.9% (HR=2.189, 95%CI: 1.393-4.459,P=0.027).Conclusion Low serum albumin level is an independent risk factor for poor clinical prognosis of patients with chronic heart failure by cardiac resynchronization therapy. It can increase the risk of all-cause death and heart failure readmission within 3 years after surgery. The preoperative serum albumin level is useful for heart assessment. The risk of death after resynchronization therapy is of great significance.

参考文献/References:

[1]涂荣会,安维维,钟国强,等.心脏再同步化治疗对慢性心力衰竭患者死亡率及死亡模式的影响[J].中国老年学杂志,2014,34(13):3602-3607. [2]Hai OY,Mentz RJ,Zannad F,et al.Cardiac resynchronization therapy in heart failure patients with less severe left ventricular dysfunction[J].European Journal of Heart Failure,2015,17(2):135-143. [3]刘深荣,朱庭延,陈燕玉,等.慢性心力衰竭患者心脏再同步化治疗应答反应的影响因素分析[J].山东医药,2017(32):87-89. [4]Stolfo D,Tonet E,Merlo M,et al.Early right ventricular response to cardiac resynchronization therapy:impact on clinical outcomes[J].European Journal of Heart Failure,2016,18(2):205-213. [5]孙欣,江勇,焦盼晴,等.心脏再同步化治疗后右心室收缩及舒张功能的早期变化[J].中国循环杂志,2013,28(2):129-131. [6]Sachse FB,Torres NS,Savio-Galimberti E,et al.Subcellular structures and function of myocytes impaired during heart failure are restored by cardiac resynchronization therapy[J].Circulation Research,2015,110(4):588-597. [7]Khairy P,Fournier A,Thibault B,et al.Cardiac resynchronization therapy in congenital heart disease[J].Herzschrittmacherther Elektrophysiol,2016,109(2):160-168. [8]Chen A,Chen X,Shen Y,et al.Modalities of ventricular pacing for cardiac resynchronization therapy in patients with heart failure:a meta-analysis and systematic review[J].Archives of Medical Ence Ams,2017,13(5):189-197. [9]张钟丹.脑钠肽、尿微量白蛋白在心力衰竭患者中的临床诊断价值[J].心血管康复医学杂志,2017,26(3):269-273. [10]任晓红,金丽,李玉荣,等.血清低白蛋白对老年心力衰竭患者院内死亡的预测价值[J].临床内科杂志,2016,33(10):679-682. [11]张兴通,赵鹃,王淼.血清白蛋白水平评价慢性心力衰竭患者心脏再同步化治疗的初步探讨[J].中国循环杂志,2015,30(4):343-345. [12]Khidir MJH,Delgado V,Ajmone Marsan N,et al.QRS duration versus morphology and survival after cardiac resynchronization therapy[J].Esc Heart Fail,2017,4(1):23-30.

相似文献/References:

[1]贺明清,刘孝娅.环磷腺苷葡胺治疗慢性心力衰竭临床疗效观察[J].医学信息,2018,31(10):135.[doi:10.3969/j.issn.1006-1959.2018.10.045]
 HE Ming-qing,LIU Xiao-ya.Clinical Efficacy of Cyclic Adenosine Glucosamine in the Treatment of Chronic Heart Failure[J].Medical Information,2018,31(15):135.[doi:10.3969/j.issn.1006-1959.2018.10.045]
[2]李鹏飞,何荣华,王琼涛,等.单胺氧化酶对老年心力衰竭患者临床应用价值[J].医学信息,2018,31(17):78.[doi:10.3969/j.issn.1006-1959.2018.17.023]
 LI Peng-fei,HE Rong-hua,WANG Qiong-tao,et al.Clinical Value of Monoamine Oxidase in Elderly Patients with Heart Failure[J].Medical Information,2018,31(15):78.[doi:10.3969/j.issn.1006-1959.2018.17.023]
[3]曹 云,李树茂,裘 冬,等.益气温阳中药治疗慢性舒张性心力衰竭的疗效观察[J].医学信息,2019,32(01):162.[doi:10.3969/j.issn.1006-1959.2019.01.051]
 CAO Yun,LI Shu-mao,QIU Dong,et al.Therapeutic Effect of Yiqiwenyang Chinese Medicine on Chronic Diastolic Heart Failure[J].Medical Information,2019,32(15):162.[doi:10.3969/j.issn.1006-1959.2019.01.051]
[4]聂今心,丁振江,段华莹.心力衰竭患者血清脑钠肽和白蛋白相关性分析[J].医学信息,2019,32(05):98.[doi:10.3969/j.issn.1006-1959.2019.05.029]
 NIE Jin-xin,DING Zhen-jiang,DUAN Hua-ying.Correlation between Serum Brain Natriuretic Peptide and Albumin in Patients with Heart Failure[J].Medical Information,2019,32(15):98.[doi:10.3969/j.issn.1006-1959.2019.05.029]
[5]韩婷婷,王 虹,吴美美,等.N-proBNP对慢性心衰患者发生肺动脉高压的预测价值[J].医学信息,2019,32(05):114.[doi:10.3969/j.issn.1006-1959.2019.05.035]
 HAN Ting-ting,WANG Hong,WU Mei-mei,et al.Predictive Value of N-proBNP for Pulmonary Hypertension in Patients with Chronic Heart Failure[J].Medical Information,2019,32(15):114.[doi:10.3969/j.issn.1006-1959.2019.05.035]
[6]李 月,胡 雅,曹春乐,等.慢性心力衰竭患者健康心理控制源与自我管理的相关性研究[J].医学信息,2019,32(05):133.[doi:10.3969/j.issn.1006-1959.2019.05.042]
 LI Yue,HU Ya,CAO Chun-le,et al.Correlation between Health Psychological Control Sources and Self-management in Patients with Chronic Heart Failure[J].Medical Information,2019,32(15):133.[doi:10.3969/j.issn.1006-1959.2019.05.042]
[7]张文波,杨玉雯.希氏束起搏在慢性心力衰竭患者中的应用[J].医学信息,2019,32(10):41.[doi:10.3969/j.issn.1006-1959.2019.10.015]
 ZHANG Wen-bo,YANG Yu-wen.Application of His Bundle Pacing in Patients with Chronic Heart Failure[J].Medical Information,2019,32(15):41.[doi:10.3969/j.issn.1006-1959.2019.10.015]
[8]陈云娥,李 璠,张子怡,等.营养支持治疗对终末期恶性肿瘤患者临床结局影响的Meta分析[J].医学信息,2019,32(19):63.[doi:10.3969/j.issn.1006-1959.2019.19.019]
 CHEN Yun-e,LI Fan,ZHANG Zi-yi,et al.Meta-analysis of Effect of Nutritional Support Therapy on Clinical Outcome of Patients with Terminal-stage Malignant Tumor[J].Medical Information,2019,32(15):63.[doi:10.3969/j.issn.1006-1959.2019.19.019]
[9]张凤娜,高伟勤.6min步行试验训练对慢性心力衰竭患者心功能的影响[J].医学信息,2019,32(16):97.[doi:10.3969/j.issn.1006-1959.2019.16.030]
 ZHANG Feng-na,GAO Wei-qin.The Effect of 6min Walking Test Training on Cardiac Function in Patients with Chronic Heart Failure[J].Medical Information,2019,32(15):97.[doi:10.3969/j.issn.1006-1959.2019.16.030]
[10]蒲军亮,张 婷.沙库巴曲缬沙坦钠片联合琥珀酸美托洛尔缓释片治疗慢性心力衰竭的疗效观察[J].医学信息,2020,33(14):159.[doi:10.3969/j.issn.1006-1959.2020.14.051]
 PU Jun-liang,ZHANG Ting.Observation of Sacubitril Valsartan Sodium Tablets Combined with Metoprolol Succinate Sustained-release Tablets in the Treatment of Chronic Heart Failure[J].Medical Information,2020,33(15):159.[doi:10.3969/j.issn.1006-1959.2020.14.051]

更新日期/Last Update: 1900-01-01