中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2019, Vol. 48 ›› Issue (7): 624-628.doi: 10.12007/j.issn.0258-4646.2019.07.011

• 论著 • 上一篇    下一篇

性别差异对射血分数中间型心力衰竭患者预后的影响

韩苏, 王传合, 佟菲, 杨丽娜, 崔文佳, 孙志军   

  1. 中国医科大学附属盛京医院心内科, 沈阳 110022
  • 收稿日期:2019-05-17 出版日期:2019-07-30 发布日期:2019-07-17
  • 通讯作者: 孙志军 E-mail:sunzj@sj-hospital.org
  • 作者简介:韩苏(1988-),男,医师,硕士.
  • 基金资助:
    辽宁省科学技术计划(201800694)

Sex-Related Differences in Prognosis of Heart Failure with Mid-Range Ejection Fraction

HAN Su, WANG Chuanhe, TONG Fei, YANG Lina, CUI Wenjia, SUN Zhijun   

  1. Department of Cardiology, Shengjing Hospital, China Medical University, Shenyang 110022, China
  • Received:2019-05-17 Online:2019-07-30 Published:2019-07-17

摘要: 目的 研究性别差异是否对射血分数中间型心力衰竭患者的预后产生影响。方法 连续纳入2016年1月至2017年12月于我院接受治疗的射血分数中间型心力衰竭患者285例,其中,女124例(43.5%),男161例(56.5%)。以出院后1年内的全因死亡为主要终点事件,通过基线对比及Cox回归分析研究是否存在性别的差异。结果 与男性组相比,女性组年龄更大,舒张末容积较小,肌酐及血红蛋白水平均较低,吸烟人数较少,但脑钠肽及低密度脂蛋白水平更高。随访期间,全因死亡率为24.2%,男性组为25.9%,女性组为22.0%。Cox单因素生存分析结果(HR=0.918;95% CI:0.566,1.488;P=0.728)及Cox多因素生存分析结果(HR=0.774;95% CI:0.324,1.850;P=0.565)显示,不同性别患者的预后无统计学差异。不同性别组Cox多因素分析结果提示,高龄及恶化的心功能为男性组和女性组共同的危险因素,但钠离子的持续下降是男性组不同于女性组的独立危险因素。结论 性别差异对射血分数中间型心力衰竭患者的预后无显著影响,但不同性别患者预后的独立危险因素不同。

关键词: 射血分数中间型心力衰竭, 性别差异, 预后

Abstract: Objective To investigate the relationship between sex and prognosis in patients with heart failure with mid-range ejection fraction(HFmrEF). Methods We enrolled 285 patients with HFmrEF who were admitted to our hospital between January 2016 and December 2017. The study included 124 female(43.5%)and 161 male(56.5%)subjects. Baseline and Cox regression analyses were used; the primary endpoint was all-cause mortality within one year after discharge. Results The female group included older patients and fewer smokers than the male group. Additionally,the female patients had smaller systolic volume,and lower creatinine and hemoglobin levels, but higher levels of brain natriuretic peptide and low-density lipoprotein. During the follow-up period,the overall all-cause mortality rate in patients with HFmrEF was 24.2%,corresponding to 25.9% and 22.0% in the male and female groups,respectively. Both Cox univariate[hazard ratio(HR)=0.918,95% confidence interval(CI)0.566-1.488,P=0.728]and Cox multivariate(HR=0.774,95% CI 0.324-1.850, P=0.565)survival analyses showed no significant difference in the prognosis of patients of different sexes. Nonetheless,Cox multivariate analysis of the individual groups indicated that age and worse cardiac function were risk factors of prognosis in both groups,while the continuing decrease in blood sodium was an independent risk factor in male patients. Conclusion Sex has no significant effect on the prognosis of patients with HFmrEF. However,the independent predictive factors of worse prognosis vary with sex.

Key words: heart failure with mid-range ejection fraction, gender difference, prognosis

中图分类号: 

  • R541.6
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