CAJ | 학술논문

目的探讨袢利尿剂对慢性心力衰竭患者肾功能的影响.方法采用病例对照研究方法,分析袢利尿剂应用与肾功能恶化发生有无统计学关联,是否为其发生的独立危险因素.以住院期间任何时间出现的肌酐值较入院时升高≥26.5 μmol/L作为肾功能恶化的标准,分为病例组(肌酐≥26.5umol/L,66例)及对照组(肌酐＜26.5 μmol/L,145例).结果病例组袢利尿剂总剂量(385.17±49.37)mg明显大于对照组(244.50±34.82)mg(P ＜0.05),但利尿剂量与肾功能恶化的发生无独立相关性(P＞0.05),入院肌酐浓度及心功能分级与肾功能恶化的发生独立相关,OR值分别为2.248(95％CI:1.088 ～4.647)和2.485(95％ CI:1.385～4.459)(P均＜0.05).结论袢利尿剂应用与肾功能恶化的发生无独立相关性,入院肌酐浓度偏高及心功能差为心力衰竭患者住院期间发生肾功能恶化的独立危险因素.
목적 탐토번이뇨제대만성심력쇠갈환자신공능적영향.방법 채용병례대조연구방법,분석번이뇨제응용여신공능악화발생유무통계학관련,시부위기발생적독립위험인소.이주원기간임하시간출현적기항치교입원시승고≥26.5 μmol/L작위신공능악화적표준,분위병례조(기항≥26.5umol/L,66례)급대조조(기항＜26.5 μmol/L,145례).결과 병례조번이뇨제총제량(385.17±49.37)mg명현대우대조조(244.50±34.82)mg(P ＜0.05),단이뇨제량여신공능악화적발생무독립상관성(P＞0.05),입원기항농도급심공능분급여신공능악화적발생독립상관,OR치분별위2.248(95％CI:1.088 ～4.647)화2.485(95％ CI:1.385～4.459)(P균＜0.05).결론 번이뇨제응용여신공능악화적발생무독립상관성,입원기항농도편고급심공능차위심력쇠갈환자주원기간발생신공능악화적독립위험인소.
Objective To describe the effect of loop diuretic on renal function in patients with chronic heart failure.Methods Data were of 211 impatients diagnosed as HF collected in a nested case-control study.The association of application of loop diuretic with renal function was assessed to identify whether loop diuretic was an independent risk factor of worsening renal function(WRF).To identify WRF,we defined serum creatinine level as a rise ≥26.5 μmol/L compared to the level at admission.Therefore,the subjects were divided into case group(serum creatinine level ≥ 26.5 μmol/L,n =66)and control group(serum creatinine level ＜ 26.5μmol/L,n =145).Results The doses of loop diuretic were higher in the case group([385.17 ± 49.37]mg)than the control group([244.50 ± 34.82]ag)(P ＜ 0.05),but it was not independent risk factor of WRF (P＞0.05).Creatinine level and NYHA class at admission were independent risk factor for WRF,with OR of 2.248(95 ％ CI:1.088-4.647)and 2.485(95 ％ CI:1.385-4.459)respectively(Ps ＜ 0.05).Conclusion The doses ofloop diuretic were not independent risk factor of WRF,creatinine level and severity of HF at admission are the most important predictors of the occurrence of WRF.