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目的观察老年男性肺炎合并心力衰竭患者血钾水平变化,探讨其对预后的影响。方法选取2014年1—10月中国人民解放军324医院收治的老年男性肺炎合并心力衰竭老年患者56例,根据纽约心脏病协会(NYHA)心功能分级分为Ⅱ级组17例,Ⅲ级组24例,Ⅳ级组15例;根据血清B型钠尿肽(BNP)水平分为1级组14例(100~499μg/L),2级组17例(500~999μg/L),3级组25例(≥1 000μg/L)组;根据血钾水平分为低钾血症组22例(<3.5 mmol/L),正常血钾组24例(3.5~5.5 mmol/L),高钾血症组10例(>5.5 mmol/L)。比较不同心功能分级、血清BNP水平患者血清C反应蛋白(CRP)水平和血钾水平,不同血钾水平患者预后。结果不同心功能分级、血清BNP水平患者血清CRP水平比较,差异均无统计学意义(P>0.05)。心功能Ⅳ级组患者血钾水平高于Ⅲ级组、Ⅱ级组,心功能Ⅲ级组高于Ⅱ级组(P<0.05);血清BNP水平3级组患者血钾水平高于2级组、1级组,2级组高于1级组(P<0.05)。血清CRP水平与血钾水平无直线相关性(r=0.159,P=0.242)。高钾血症组患者生存率低于低钾血症组、正常血钾组(P<0.05)。结论心功能分级差、血清BNP水平高的老年男性肺炎合并心力衰竭老年患者血钾水平较高,且血钾水平较高者预后较差。
Objective To investigate the changes of serum potassium levels in elderly patients with pneumonia complicated with heart failure and to explore their effects on prognosis. Methods Fifty-six elderly patients with pneumonia complicated with heart failure admitted to Chinese People’s Liberation Army 324 Hospital from January to October 2014 were divided into two groups according to the New York Heart Association (NYHA): 17 cases in grade Ⅱ, 24 cases in Ⅲ (N = 15). According to the level of serum BNP, 14 cases (100-499 μg / L) in grade 1 group, 17 cases (500-9999 μg / L) in grade 2 group and 25 (≥1 000μg / L). According to the level of serum potassium, 22 cases (<3.5 mmol / L) of hypokalemia group, 24 cases (3.5-5.5 mmol / L) of normal potassium group and hyperkalemia Group 10 cases (> 5.5 mmol / L). The levels of serum C-reactive protein (CRP), serum potassium level and prognosis of patients with different levels of serum potassium in patients with different levels of cardiac function, serum BNP levels were compared. Results There was no significant difference in serum CRP level between patients with different cardiac function grade and serum BNP level (P> 0.05). The serum potassium level in patients with grade IV cardiac function was significantly higher than those in grade III, grade II and grade III patients (P <0.05). The level of serum potassium in patients with grade 3 BNP was higher than that in patients with grade 2 , Level 1, level 2 were higher than level 1 (P <0.05). There was no linear correlation between serum CRP level and serum potassium level (r = 0.159, P = 0.242). The survival rate of hyperkalemia group was lower than that of hypokalemia group and normal potassium group (P <0.05). Conclusion Elderly men with pneumothorax and heart failure who have poor cardiac function and high serum BNP levels have higher serum potassium levels and higher serum potassium levels, and their prognosis is poor.