河北医科大学学报

• 论著 • 上一篇    下一篇

老龄心力衰竭患者出院时收缩压水平与预后的关系

  

  1. 1.江苏省盐城市第一人民医院老年医学科,江苏 盐城 224000;2.江苏省盐城市第一人民医院普外科,
    江苏 盐城 224000;3.江苏省盐城市第一人民医院内分泌科, 江苏 盐城 224000
  • 出版日期:2016-06-25 发布日期:2017-01-16
  • 作者简介:单湘湘( 1975- ),女,江苏盐城人,江苏省盐城市第 一人民医院副主任医师,医学学士,从事老年糖尿病诊治研究。

The relationship between systolic blood pressure and prognosis of elder patients with heart failure when discharged from hospital

  1. 1.Department of Geriatric Medicine, the First People's Hospital of  Yancheng City, Jiangsu Province,
    Yanchong 224000, China; 2.Department of General Surgery, the First People's Hospital of Yancheng
    City, Jiangsu Province, Yanchong 224000, China; 3.Department of Endocrinology, the First
    People's Hospital of Yancheng City, Jiangsu Province, Yanchong 224000, China
  • Online:2016-06-25 Published:2017-01-16

摘要: [摘要] 目的 探讨老龄心力衰竭患者出院时收缩压( systolicbloodpressure , SBP )对于预后判断的价值。方
法 回顾性分析 35 例因心力衰竭住院治疗患者的临床资料,根据患者出院时平均 SBP 分为 3 组,即 SBP<100
mmHg组( A 组)、100~140mmHg 组( B 组)、 >140mmHg 组( C 组),对其进行为期 2 年的随访,随访内容包括院
外生存情况、脑钠肽( brainnatriureticpeptide ,BNP )、肌钙蛋白( cTn ),尤其关注院外死亡患者出院前 24h 动态 SBP
监测情况。结果 3 组生存率差异有统计学意义( P <0.05 ); 3 组出院后 2 年内 BNP 水平组间差异无统计学意义
( P >0.05 ),时点间、组间·时点间交互作用差异有统计学意义( P <0.05 ),其中 A 组上升明显( P <0.05 );
cTn 随访阳性情况,出院 3 个月时 A 组与 B 组阳性例数多于 C 组,出院 6 个月时 A 组多于 B 、 C 组,出院 1 、 2 年时 A 组多
于 B 、 C 组且 B 组多于 C 组,差异均有统计学意义( P <0.05 );随访 2 年内事件组 25 例(死亡)与非事件组 9 例(生
存)出院前 24h 动态 SBP 水平差异有统计学意义( P <0.05 ),事件组出院前 SBP 水平显著降低( P <0.05 )。结论
SBP 可作为老龄患者出院时有效判断预后的指标,临床医生对于 SBP 较低的心力衰竭患者应采取有效对策。

关键词: 心力衰竭, 血压, 老年人

Abstract: Abstract] ObjectiveTo investigate the relationship between prognosis and systolic blood pressure(SBP) of elder patients with heart failure. MethodsClinical datas of 35 patients with heart failure from Nov.2009 to Nov.2014 were retrospectively nanlyzed. According to the mean systolic blood pressure, 34(1 patient lost) patients were divided into group A(SBP<100 mmHg), group B(SBP 100-140 mmHg), group C(SBP>140 mmHg). The clinical statistics such as the survive time, BNP, cardiac troponin(cTn) and especially the 24 hour ambulatory blood pressure statistics of the patiens died were collected in two years. ResultsSurvival rate of elderly patients among different SBP showed significant difference(P<0.05); Three groups of elderly patients within 2 years after hospital discharge showed difference between time and the point of interaction(P>005) but no differences between groups. CTn positive rate was statistically significant difference among the 3 groups(P<005). The cTn positive rate in group A and the group C were higher than those in group C at 3 months. The cTn positive rate in group A were higher than those in group B and the group C at 6 months. The cTn positive rate in group A were higher than those in group B and the group C at 1to 2 years, and group A were higher than those in group B(P<005). Within 2 years of followup, 25 patients (death) in the event group and 9 patients (survival) in the non event group had significant difference in the dynamic SBP level 24 h before discharged from hospital(P<005). The event group had lower dynamic SBP than the survival group(P<005). ConclusionSBP can be used as an index to judge the prognosis of elderly patients discharged from hospital. Clinicians should take effective measures for patients with SBP with lower heart failure.

Key words: heart failure, blood pressure, aged