急性心力衰竭患者发生1型心肾综合征的风险预警评分

王银娜; 越桐; 程虹; 谌贻璞

doi:10.13201/j.issn.1001-1439.2014.06.013

急性心力衰竭患者发生1型心肾综合征的风险预警评分

- 1 首都医科大学附属北京安贞医院肾内科(北京, 100029);
- 2 首都医科大学附属复兴医院肾内科
基金项目:
首都特色临床医学应用发展项目 (No:D101100050010017)

首都卫生发展科研专项 (No:首发2011-2006-07)

详细信息

通讯作者: 程虹,E-mail:chenghong65@medmail.com.cn

中图分类号: R541.6

收稿日期: 2013-11-24

Prediction risk score for type 1cardiorenal syndrome in patients with acute heart failure

- Department of Nephrology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China

More Information

Corresponding author: CHENG Hong, E-mail: chenghong65@medmail.com.cn

Received Date: 24 November 2013

摘要

摘要: 目的:创建并验证急性心力衰竭 (AHF) 患者发生1型心肾综合征 (CRS) 的预警评分。方法:对1 709例AHF病例进行回顾性分析, 随机选取60%的病例 (1 010例) 进行Logistic回归分析并创建预警评分, 其余40% (699例) 进行验证。结果:AHF患者1型CRS的发病率为32.2%。年龄 ≥ 70岁、反复心力衰竭史、收缩压＜90mmHg (1mmHg=0.133kPa)、血钠＜130mmol/L、心功能Ⅳ级、蛋白尿、基线血肌酐 (SCr) ≥ 104μmol/L及静脉呋塞米最大日剂量 ≥ 80mg/d是1型CRS发生的独立危险因素。依据各危险因素β偏回归系数并结合临床建立预警评分, 评分最佳诊断分界点为8分, ≥ 8分的患者1型CRS发病率较＜8分患者显著增加 (55.1%:18.0%, P＜0.01)。经验证该预警评分具有较好的鉴别力及校准度。结论:本研究所创建的预警评分能有效地预测AHF患者1型CRS的发生, 可供临床应用。
- 急性心力衰竭 /
- 心肾综合征 /
- 急性肾损伤 /
- 危险因素 /
- 评分
Abstract: Objective: To derive and validate a prediction score for type 1cardiorenal syndrome (CRS) in patients with acute heart failure (AHF).Method: The hospital medical records of 1 709 patients with AHF were reviewed.The patients were randomly divided into derivation dataset (accounting for 60% cases) and validation dataset (40% cases).A multivariate logistic regression analysis was undertaken to derive a prediction score.Result: Type 1CRS developed in 32.2% of patients with AHF.Factors independently associated with the risk of type 1CRS included: ≥ 70years of age, ≥ 3 times of heart failure history, systolic blood pressure＜90mmHg, serum sodium ＜130mmol/L, heart functional classⅣ, proteinuria, SCr ≥ 104μmol/L, and intravenous furosemide dose ≥ 80mg/d.A prediction score for type 1CRS was derived based on theβcoefficient of each risk factor.Patients with ≥ 8 points would be considered at high risk for development of type 1CRS (55.1% incidence vs 18% in those with＜8 points, P＜0.01).Both the derivation and validation datasets showed adequate discrimination and good calibration.Conclusion: This clinical prediction score may effectively predict type 1CRS in the patients with AHF.
- acute heart failure /
- cardiorenal syndrome /
- acute kidney injury /
- risk factor /
- score

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参考文献(6)

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