CAJ | 학술논문

目的：分析低钠血症与慢性心力衰竭（CHF）的相关性及预后的关系。方法 CHF住院患者（CHF组）507例及同期非心衰患者（非心衰组）212例，考察2组一般资料情况；将差异有统计学意义的指标为自变量，通过多元Logistic分析血钠与CHF的关系；随访结果分析血钠与CHF患者病死率和再入院率的关系，并进一步分析血钠与脑钠肽（BNP）、左射血分数（LVEF）保留心衰（LVEF≥0.45，HFpEF）和LVEF减低心衰（LVEF<0.45，HFrEF）预后的关系。结果2组比较，性别、吸烟史等差异无统计学意义（P＞0.05），年龄、血红蛋白、血钠等差异有统计学意义（P＜0.05）；血钠是CHF的保护因素。低钠血症组（Na+<135 mmol/L）BNP浓度高于非低血钠组(P＜0.05)；LVEF差异无统计学意义。CHF患者中低钠血症组病死率高于非低血钠组（P＜0.05），而再入院率差异无统计学意义（P＞0.05）， HFpEF患者中低钠血症组和非低血钠组病死率及再入院率差异均有统计学意义（P＜0.05）。结论血钠是CHF的保护因素，HFpEF合并低钠血症者远期更易死亡及再入院。
목적：분석저납혈증여만성심력쇠갈（CHF）적상관성급예후적관계。방법 CHF주원환자（CHF조）507례급동기비심쇠환자（비심쇠조）212례，고찰2조일반자료정황；장차이유통계학의의적지표위자변량，통과다원Logistic분석혈납여CHF적관계；수방결과분석혈납여CHF환자병사솔화재입원솔적관계，병진일보분석혈납여뇌납태（BNP）、좌사혈분수（LVEF）보류심쇠（LVEF≥0.45，HFpEF）화LVEF감저심쇠（LVEF<0.45，HFrEF）예후적관계。결과2조비교，성별、흡연사등차이무통계학의의（P＞0.05），년령、혈홍단백、혈납등차이유통계학의의（P＜0.05）；혈납시CHF적보호인소。저납혈증조（Na+<135 mmol/L）BNP농도고우비저혈납조(P＜0.05)；LVEF차이무통계학의의。CHF환자중저납혈증조병사솔고우비저혈납조（P＜0.05），이재입원솔차이무통계학의의（P＞0.05）， HFpEF환자중저납혈증조화비저혈납조병사솔급재입원솔차이균유통계학의의（P＜0.05）。결론혈납시CHF적보호인소，HFpEF합병저납혈증자원기경역사망급재입원。
Abstrsct:Objective To analyze the correlation of hyponatremia with chronic heart failure (CHF) and the prognostic analysis of CHF. Methods Patients with CHF (n=507) and healthy adult (n=212) were included in this study. The general data of the two groups were analysed. The index which was statistically significant was indicated as independent variables. Multivariate logistic analysis was used to analysis the correlation between serum sodium and CHF. The relationship between serum sodium and the prognosis of CHF include mortality and rate of readmission were included in follow-up study. The prognostic correlation of serum sodium with BNP (brain natriuretic peptide), heart failure with preserved ejection fraction (HFpEF, LVEF≥0.45) and heart failure with reduced ejection fraction (HFrEF, LVEF<0.45) were all analyzed. Results In?dicators such as sex, smoking history showed no statistical significance between two groups (P>0.05) while other indicators like age, hemoglobin, serum sodium presents statistical significance (P < 0.05). Serum sodium is the protective factor for CHF. Brain natriuretic peptide (BNP) concentration in hyponatremia group is significantly higher than that in normal serum sodium group (P<0.05). HFpEF and HFrEF were of no significant difference in these two groups. For patients with CHF, the mortality in hyponatremia group is significantly higher than that in normal serum sodium group (P<0.05), but readmission rates were not significantly different (P>0.05);While for patients with HFpEF, the mortality and the readmission rates were both significantly different (P<0.05). Conclusion Serum sodium is the protective factor in CHF, the patients with hypona?tremia have higher readmission rate and death rate in HFpEF background.