慢性肾脏病患者心包积液的临床特征和预后分析

姚维; 钱进; 王能; 刘玉文

doi:10.13201/j.issn.1001-1439.2019.07.014

慢性肾脏病患者心包积液的临床特征和预后分析

- 湖北医药学院附属随州医院(随州市中心医院)心内科(湖北随州,441300)

详细信息

通讯作者: 姚维, E-mail:yaowei-2006@163.com

中图分类号: R692;R542.12

收稿日期: 2019-04-02

Clinical characteristics and prognosis of patients with chronic kidney disease and pericardial effusion

- Department of Cardiology Medicine, Affiliated Hospital of Hubei University of Medicine, Suizhou Central Hospital, Suizhou, Hubei, 441300, China

More Information

Corresponding author: YAO Wei, E-mail: yaowei-2006@163.com

Received Date: 02 April 2019

摘要

摘要: 目的:分析慢性肾脏病伴心包积液患者的临床特征和影响因素, 并研究其与预后的关系。方法:纳入在我院治疗的慢性肾脏病患者, 分为心包积液组 (139例) 和无心包积液组 (142例) , 比较两组的临床特征, 分析心包积液的危险因素;随访12个月因心血管疾病再次入院和心源性死亡事件, 分析其影响因素。结果:与无心包积液组比较, 心包积液组钾离子 (K+) 、血尿素氮 (BUN) 、肌酐 (Cr) 浓度较高, 而钙离子 (Ca2+) 、血红蛋白 (Hb) 、肾小球滤过率 (GFR) 、白蛋白水平均较低, 差异均有统计学意义 (均P<0.01) ;Logistic回归分析显示, 快心率 (OR:1.43;95%CI:1.04~1.98) 、高K+ (OR:2.14;95%CI:1.32~3.17) 、高Ca2+ (OR:1.37;95%CI:1.09~1.76) 、低白蛋白 (OR:1.86;95%CI:1.22~2.93) 是心包积液的危险因素 (均P<0.05) 。随访结果显示, 心包积液显著增加因心血管疾病再次入院率 (58/139∶41/142, P=0.02) , 而不增加心源性死亡率 (9/139∶10/142, P=0.52) 。Cox回归分析显示, 中重度心包积液 (HR:2.15;95%CI:1.29~3.48) 、终末期肾衰竭 (HR:1.76;95%CI:1.16~2.51) 、高K+ (HR:1.54;95%CI:1.07~2.29) 、低白蛋白 (HR:1.62;95%CI:1.14~2.37) 是12个月联合事件的独立危险因素 (均P<0.05) 。结论:慢性肾脏病患者心包积液与快心率、高K+、高Ca2+、低白蛋白相关, 心包积液增加慢性肾脏病患者12个月的因心血管疾病再次入院率, 其与中重度心包积液、高K+、低白蛋白密切相关。
- 心包积液 /
- 慢性肾脏病 /
- 危险因素 /
- 预后
Abstract: Objective:To investigate the clinical features, prognosis and influencing factors of chronic kidney disease combined with pericardial effusion.Method:Patients with chronic kidney disease were divided into pericardial effusion group (n=139) and non-pericardial effusion group (n=142) .Clinical characteristics between two group were compared, and risk factors of pericardial effusion were analyzed.In addition, cardiovascular re-admission and cardiac death were recorded during the follow-up of 12 months.Finally, influencing factors were analyzed.Result:Compared with those in the non-pericardial effusion group, the concentration of potassium ion (K+) , blood urea nitrogen (BUN) and creatinine (Cr) in the pericardial effusion group were higher, while the levels of calcium ion (Ca2+) , hemoglobin (Hb) , glomerular filtration rate (GFR) and albumin were lower in the pericardial effusion group (all P<0.01) .Logistic regression analysis showed that fast heart rate (OR:1.43;95%CI:1.04-1.9) , high K+ (OR:2.14;95%CI:1.32-3.17) , high Ca2+ (OR:1.37;95%CI:1.09-1.76) and low albumin (OR:1.86;95%CI:1.22-2.93) were risk factors for pericardial effusion (all P<0.05) .Follow-up results showed that pericardial effusion significantly increased the rate of re-hospitalization due to cardiovascular diseases (58/139 vs.41/142, P=0.02) , but did not increase cardiac mortality (9/13 vs.10/142, P=0.52) .Cox regression analysis showed that moderate to severe pericardial effusion (HR:2.15;95%CI:1.29-3.48) , end-stage renal failure (HR:1.76;95%CI:1.16-2.51) , high K+ (HR:1.54;95%CI:1.07-2.29) , low albumin (HR:1.62;95%CI:1.14-2.37) were independent risk factors for 12-month combined events (all P<0.05) .Conclusion:Pericardial effusion is associated with fast heart rate, high K+, high Ca2+and low albumin in patients with chronic kidney disease.Pericardial effusion increases the rate of re-hospitalization within 12 months due to cardiovascular diseases.Moderate to severe pericardial effusion, high K+, and low albumin are independent risk factor.
- chronic kidney disease /
- pericardial effusion /
- risk factor /
- prognosis

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