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目的探讨慢性肾脏病(CKD)患者发生心衰的危险因素。方法将366例CKD患者按2002年K/DOQI慢性肾脏病的分期标准分为5期,再按是否发生心衰分为2组,比较两组患者年龄、既往病史、吸烟史、心电图T波改变、血红蛋白(Hb)、C反应蛋白(CRP)、血脂、血压等方面的变化以及住院期间两组患者的病死率。结果发生心衰组的年龄升高,有既往高血压、糖尿病、冠心病、吸烟史者、心电图T波改变均比未发生心衰组明显增多(P<0.05);心衰组C反应蛋白(CRP)、高密度脂蛋白胆固醇(HDL-L)、舒张压(DBP)均比未心衰组明显升高(P<0.01),而Hb、低密度脂蛋白胆固醇(LDL-L)则比未心衰组明显降低(P<0.01)结论患者年龄升高、既往有心血管病史、吸烟、CRP水平、Hb水平是CKD患者发生心衰的独立危险因素,针对性地干预这些危险因素,有可能降低心衰的发生率和病死率,改善CKD患者的预后。
Objective To investigate the risk factors of heart failure in patients with chronic kidney disease (CKD). Methods 366 patients with CKD were divided into 5 stages according to the staging of K / DOQI chronic kidney disease in 2002. The patients were divided into 2 groups according to whether they had heart failure or not. The age, past medical history, smoking history, ECG T wave changes , Hemoglobin (Hb), C-reactive protein (CRP), blood lipids, blood pressure and other aspects of the change and hospitalization during the two groups of patients mortality. Results The age of HF group was higher than that of non-HF group (P <0.05). There was a history of previous hypertension, diabetes mellitus, coronary heart disease, and smoking history. CRP, HDL-L and DBP were significantly higher than those without heart failure (P <0.01), while Hb and LDL-L were lower than those without heart failure Heart failure group was significantly lower (P <0.01) Conclusions Patients with age, previous history of cardiovascular disease, smoking, CRP levels, Hb levels are independent risk factors for heart failure in patients with CKD, targeted intervention of these risk factors may be reduced The incidence of heart failure and mortality, improve the prognosis of patients with CKD.