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PLOS ONE:心力衰竭患者的预后:钠含量是否起重要作用?

2018-11-10 海北 MedSci原创

心力衰竭(HF)是一种主要的心血管疾病,无论医疗保健的进展如何,如今,它仍然是一种严重的临床症状。低钠血症被归类为血清钠浓度<135 mEq / L,心力衰竭患者低钠血症的患病率,临床影响和预后因素差异很大。

心力衰竭(HF)是一种主要的血管疾病,无论医疗保健的进展如何,如今,它仍然是一种严重的临床症状。低钠血症被归类为血清钠浓度<135 mEq / L,心力衰竭患者低钠血症的患病率,临床影响和预后因素差异很大。
最近,研究人员进行了一项探究,旨在评估住院诊断为HF的患者的低钠血症患病率,并根据其钠状态比较HF患者的基线临床特征。研究人员还评估了低钠血症和正常血症患者之间的存活差异,并评估了HF患者总体死亡率的临床预后指标。
这是一项回顾性队列研究,旨在评估入住Gondar大学转诊医院的心力衰竭患者的医疗记录。患者在首次入住内科时根据其钠水平状况进行分类。每位患者被分配到以下任一组:如果钠<135 mmol / L,则为低钠血症;如果钠≥135mmol / L,则为正常组。
在388名参与者中,研究队列中低钠血症的患病率为51.03%。Kaplan-Meier生存曲线显示,两组中HF患者的生存状态存在显着差异(Log-Rank检验,P <0.0001)。钠水平正常的患者比低钠血症患者存活的机会更高。
多变量Cox回归显示死亡率与以下变量具有统计学显着相关性:高龄(AHR = 1.035(1.012-1.058),P = 0.003),低钠血症(AHR = 4.003(1.778-9.009),P = 0.001),更高肌酐水平(AHR = 1.929(1.523-2.443),P = <0.0001),血管紧张素转换酶抑制剂(AHR = 0.410(0.199-0.842),P = 0.015)和螺内酯(AHR = 0.511(0.275-0.949)) ),P = 0.033)。
总之,低钠血症是心力衰竭患者临床预后的关键因素之一。然而,由于其他预后因素(即药物,肌酸水平和年龄)也在总体生存中发挥重要作用,因此需要进行良好对照的临床试验(完成药物剂量,实验室产出和长期前瞻性随访),以进一步研究在低收入国家低钠血症对HF患者预后的影响。

原始出处:
Abebe TB et al. The prognosis of heart failure patients: Does sodium level play a significant role? PLOS ONE 2018, DOI: 10.1371/journal.pone.0207242. eCollection 2018.

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    2018-11-11 一天没事干

    很好的学习机会

    0

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    2018-11-11 医者仁心5538

    学习了

    0

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