论文部分内容阅读
目的:明确稳定型慢性心力衰竭患者中氯离子的异常对于患者的病因以及随访一年内症状的影响。方法:对2014年5月至2015年5月随访的稳定型慢性心力衰竭患者进行为期一年的随访,明确患者心力衰竭的病因后,对患者的中风发生、BMI、体内胆固醇、HDL、LDL、甘油三酯、血糖、肌酐以及与心脏功能相关参数如心率、左心室射血分数、左心室舒张末期内径、左室收缩末内径进行定期测定。结果:在患者的随访中,氯离子的浓度对于稳定型慢性心力衰竭的BMI、体内胆固醇、HDL、LDL、甘油三酯、血糖、肌酐、心脏功能相关参数如心率、左心室射血分数、左心室质量、左心室舒张末期内径、左室收缩末内径均无明显影响,而在中风发生中,氯离子浓度偏低的患者在一年内中风发生的人数为18,占氯离子降低组的36%,远高于氯离子正常组的6名、13%以及氯离子浓度升高的7,12%,使用标准倾向评分匹配后中风组患者氯离子浓度93±1.2mmol/L,明显低于非中风组的102±0.6mmol/L,在ROC曲线中,氯离子浓度低于96mmol/L对于中风的预测敏感度为87%、特异度为74%,曲线下面积为0.923,95%置信区间为0.852-0.994,P<0.001。结论:氯离子浓度的降低对于稳定型慢性心力衰竭患者的中风发生具有预测作用。
OBJECTIVE: To determine the effect of chloride ion abnormalities on the etiology of patients and symptoms within one year of follow-up in patients with stable chronic heart failure. Methods: The patients with stable chronic heart failure who were followed up from May 2014 to May 2015 were followed up for one year. After the cause of heart failure was clarified, the incidence of stroke, BMI, cholesterol, HDL, LDL, Triglycerides, blood glucose, creatinine and heart function related parameters such as heart rate, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end-systolic diameter were measured regularly. Results: At follow-up of patients, the concentrations of chloride ion were positively correlated with BMI, cholesterol, HDL, LDL, triglyceride, glucose, creatinine, cardiac function related parameters such as heart rate, left ventricular ejection fraction There was no significant difference in LV mass, left ventricular end-diastolic diameter and left ventricular end-systolic diameter. In stroke, the number of stroke patients with low chloride ion concentration was 18% in one year and 36% , Which was much higher than that of 6, 13% and 7,12% of the normal chloride group, and the chloride ion concentration of 93 ± 1.2mmol / L in the stroke group was significantly lower than that of the non-stroke group Group, 102 ± 0.6 mmol / L. In the ROC curve, the chloride ion concentration of less than 96 mmol / L had a predictive sensitivity of 87% for stroke, a specificity of 74%, an area under the curve of 0.923, and a 95% confidence interval of 0.852 -0.994, P <0.001. Conclusion: The decrease of chloride ion has a predictive value for stroke in patients with stable chronic heart failure.