|本期目录/Table of Contents|

[1]刘洪泽,李广平.低氯血症增加慢性心力衰竭患者住院时间及院内死亡率[J].天津医科大学学报,2017,23(04):334-336.
 LIU Hong-ze,LI Guang-ping.Hypochloremia is associated with longer hospital stay and higher in-hospital mortality in patients with chronic heat failure[J].Journal of Tianjin Medical University,2017,23(04):334-336.
点击复制

低氯血症增加慢性心力衰竭患者住院时间及院内死亡率(PDF)
分享到:

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
23卷
期数:
2017年04期
页码:
334-336
栏目:
临床医学
出版日期:
2017-07-02

文章信息/Info

Title:
Hypochloremia is associated with longer hospital stay and higher in-hospital mortality in patients with chronic heat failure
文章编号:
1006-8147(2017)04-0334-03
作者:
刘洪泽李广平
(天津医科大学第二医院心脏科,天津市心血管病离子与分子机能重点实验室,天津心脏病学研究所,天津 300211)
Author(s):
LIU Hong-ze LI Guang-ping
(Department of Cardiology, The Second Hospital, Tianjin Medical University, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, Tianjin 300211, China)
关键词:
心力衰竭 低氯血症 住院时间 院内死亡率
Keywords:
heart failure hypochloremia hospital stay in-hospital mortality
分类号:
R541
DOI:
-
文献标志码:
A
摘要:
目的:探讨慢性心力衰竭(CHF)患者低氯血症与住院时间及院内死亡风险的关系。方法:入选因CHF入院的患者341例,根据患者入院时的血氯浓度,分为低氯血症组(氯≤96 mmol/L)和正常组(氯>96 mmol/L),记录患者的年龄、性别、查体、用药史、既往病史、化验指标、左室射血分数、住院时间及院内死亡等,比较两组间基线水平及住院时间、院内死亡率有无差别。结果:CHF住院患者低氯血症的发生率为19.65%,低氯血症组二氧化碳结合力、尿素氮、尿素氮/肌酐、尿酸、总胆红素水平及口服袢利尿剂、螺内酯、合并糖尿病率均高于正常组(P<0.05),收缩压、血钠浓度低于正常组(P<0.05)。低氯血症组患者住院时间明显增加(P<0.05),院内死亡风险升高( OR为4.10, 95%置信区间 1.22-13.77, P<0.05)。结论:低氯血症增加CHF患者的住院时间及院内死亡风险。
Abstract:
Objective: To investigate the association between hypochloremia and hospital stay, as well as in-hospital mortality in patients with chronic heart failure (CHF). Methods: Three hundred and forty-one patients with CHF were included. Hypochloremia was defined as serum chloride ≤96 mmol/L based on admission serum chloride. Normochloremia was defined as serum chloride >96mmol/L. The baseline clinical data were collected and compared between two groups, including age, sex, physical examination, prior medication use, past medical history, laboratory values, hospital stay and number of deaths in hospital. The parameters between the two groups were compared. Results: Hypochloremia was present in 19.65% of patients with CHF. The values in carbon dioxide combing power, blood urea nitrogen, blood urea nitrogen to creatine ratio, uric acid, total bilirubin, the use of loop diuretics and spirolactone, history of diabetes were significantly higher in hypochloremia group (P<0.05), and systolic blood pressure and serum sodium were significantly lower than normochloremia group (P<0.05). The hospital stays were longer in hypochloremia group than normochloremia group (P<0.05). The in-hospital mortality was higher in hypochloremia group than normochloremia group (OR:4.10, 95%CI: 1.22-13.77, P<0.05). Conclusion: CHF patients with hypochloremia have a longer hospital stay and significantly higher in-hospital mortality.

参考文献/References:

[1]Rusinaru D, Tribouilloy C, Berry C, et al. Relationship of serum sodium concentration to mortality in a wide spectrum of heart failure patients with preserved and with reduced ejection fraction:an individual patient data meta-analysis(dagger):Meta-Analysis Global Group in Chronic heart failure(MAGGIC)[J]. Eur J Heart Fail, 2012, 14(10): 1139

[2]Konstam M A, Gheorghiade M, Burnett J , et al. Effects of oral tolvaptan in patients hospitalized for worsening heart failure - The Everest outcome trial[J]. JAMA, 2007, 297(12): 1319

[3]Berend K, Van Hulsteijn L H, Gans R O. Chloride: the queen of electrolytes[J]. Eur J Intern Med, 2012, 23(3): 203

[4]Levy W C, Mozaffarian D, Linker D T, et al. The Seattle heart failure model - Prediction of survival in heart failure[J]. Circulation, 2006, 113(11): 1424

[5]Testani J M, Hanberg J S, Arroyo J P, et al. Hypochloraemia is strongly and independently associated with mortality in patients with chronic heart failure[J]. Eur J Heart Fail, 2016, 18(6): 660

[6]Ter Maaten J M, Damman K, Hanberg J S, et al. Hypochloremia, diuretic resistance, and outcome in patients with acute heart failure[J]. Circ Heart Fail, 2016, 9(8): e003109

[7]Radulovic B, Potocnjak I, Teresak S D, et al. Hypochloraemia as a predictor of developing hyponatraemia and poor outcome in acute heart failure patients[J]. Int J Cardiol, 2016, 212: 237

[8]Broughton J S, Hanberg J S, Rao V S, et al. Hypochloremia and diuretic resistance in heart failure: mechanistic insights[J]. J Card Fail, 2016, 22(8, S): S8

[9]Grodin J L, Verbrugge F H, Ellis S G, et al. Importance of abnormal chloride homeostasis in stable chronic heart failure[J]. Circ Heart Fail, 2016, 9(1): e002453

[10]Grodin J L, Simon J, Hachamovitch R, et al. Prognostic role of serum chloride levels in acute decompensated heart failure[J]. J Card Fail, 2015, 21(8, S): S89

[11]Yancy C W, Jessup M, Bozkurt B, et al. 2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF/AHA guideline for the management of heart failure a report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart failure society of America[J]. Circulation, 2016, 134(13): E282

[12]Yunos N M, Bellomo R, Story D, et al. Bench-to-bedside review: Chloride in critical illness[J]. Critical Care, 2010, 14(4): 226

[13]Kurtz A. Control of renin synthesis and secretion[J]. Am J Hypertens, 2012, 25(8): 839

[14]Kahle K T, Ring A M, Lifton R P. Molecular physiology of the WNK kinases[J]. Annu Rev Physiol, 2008, 70: 329

[15]Subramanya A R, Yang C L, Mccormick J A, et al. WNK kinases regulate Sodium chloride and Potassium transport by the aldosterone-sensitive distal nephron[J]. Kidney Int, 2006, 70(4): 630

[16]Piala A T, Moon T M, Akella R, et al. Chloride sensing by WNK1 involves inhibition of autophosphorylation[J]. Sci Signal, 2014, 7(324): ra41

[17]Goldsmith S R, Francis G S, Cowley A W, et al. Increased plasma arginine vasopressin levels in patients with congestive heart failure[J]. J Am Coll Cardiol, 1983, 1(6): 1385

[18]Laski M E, Sabatini S. Metabolic alkalosis, bedside and bench[J]. Semin Nephrol, 2006, 26(6): 404

[19]Gandhi S, Mosleh W, Myers R B. Hypertonic saline with furosemide for the treatment of acute congestive heart failure: a systematic review and meta-analysis[J]. Int J Cardiol, 2014, 173(2): 139

相似文献/References:

[1]彭云玲,齐 新,魏丽萍,等.冠心病心力衰竭患者心率变异性分析[J].天津医科大学学报,2014,20(05):363.
 PENG Yun-ling,QI Xin,WEI Li-ping,et al.Analysis on heart rate variability in heart failure patients with coronary heart disease[J].Journal of Tianjin Medical University,2014,20(04):363.
[2]赵艳辉,丛洪良.心衰患者血清胱抑素C、嗜铬粒蛋白A与心室重构的关系[J].天津医科大学学报,2015,21(03):193.
 ZHAO Yan-hui,CONG Hong-liang.Relationship between the serum cystatin C, chromaffin grain protein A and the ventricular remodeling in patients with chronic heart failure[J].Journal of Tianjin Medical University,2015,21(04):193.
[3]徐西子,董昭杰,马向红.血同型半胱氨酸水平与冠心病慢性心衰严重程度的相关性分析[J].天津医科大学学报,2017,23(03):221.
 XU Xi-zi,DONG Zhao- jie,MA Xiang-hong.Correlation of severity of chronic heart failure with plasma homocysteine level[J].Journal of Tianjin Medical University,2017,23(04):221.
[4]赵晓彬,牛书林,袁如玉.关于急性心肌梗死早期阴离子间隙的研究[J].天津医科大学学报,2020,26(04):333.
 ZHAO Xiao-bin,NIU Shu-lin,YUAN Ru-yu.Association between initial anion gap and acute myocardial infarction[J].Journal of Tianjin Medical University,2020,26(04):333.
[5]李树杰,宋昱.急性心肌梗死后心力衰竭的特异性靶点基因研究[J].天津医科大学学报,2021,27(06):561.
 LI Shu-jie,SONG Yu.Study on specific target genes of heart failure after acute myocardial infarction[J].Journal of Tianjin Medical University,2021,27(04):561.
[6]陈巧,孙洁,李竹青,等.沙库巴曲缬沙坦对心肌梗死后不同病程心力衰竭患者的疗效评价[J].天津医科大学学报,2022,28(03):229.
 CHEN Qiao,SUN Jie,LI Zhu-qing,et al.Evaluation of efficacy of sacubitril -valsartan in patients with heart failure in different courses after myocardial infarction[J].Journal of Tianjin Medical University,2022,28(04):229.
[7]石琳,刘房春,张健,等.血尿酸及D-二聚体水平对急性心肌梗死合并心力衰竭的近期预后价值探讨[J].天津医科大学学报,2022,28(06):643.
 SHI Lin,LIU Fang-chun,ZHANG Jian,et al.The value of serum uric acid and D-dimer levels in the short-term prognosis of acute myocardial infarction complicated with heart failure[J].Journal of Tianjin Medical University,2022,28(04):643.
[8]刘晓燕,车京津.ARNI逆转广泛前壁心肌梗死后左室重构1例报告[J].天津医科大学学报,2023,29(01):88.
[9]赵晓彬,牛书林,邱久纯,等.初始血清阴离子间隙与急性ST段抬高型心肌梗死院内死亡的关系研究[J].天津医科大学学报,2023,29(02):109.
 ZHAO Xiao-bin,NIU Shu-lin,QIU Jiu-chun,et al.Relationship between initial serum anion gap and in-hospital mortality in patients with acute ST-segment elevation myocardial infarction[J].Journal of Tianjin Medical University,2023,29(04):109.
[10]陶文岐,姚朱华.达格列净或沙库巴曲缬沙坦对急性心肌梗死大鼠的作用机制探讨[J].天津医科大学学报,2023,29(04):406.
 TENG Jie,CHEN Ye-gangTAO Wen-qi.Exploring the mechanism of protective effect of dapagliflozin or sacubitril/valsartan in rats with acute myocardial infarction[J].Journal of Tianjin Medical University,2023,29(04):406.

备注/Memo

备注/Memo:
作者简介 刘洪泽(1990-),男,硕士在读,研究方向:心血管疾病的基础与临床;

通信作者:李广平,E-mail tjcardiol@126.com。

更新日期/Last Update: 2017-07-01