【摘要】 目的探讨老龄心力衰竭患者出院时收缩压(systolic blood pressure,SBP)对于预后判断的价值。方法回顾性分析35例因心力衰竭住院治疗患者的临床资料,根据患者出院时平均SBP分为3组,即SBP<100mmHg组(A组)、100~140mmHg组(B组)、>140mmHg组(C组),对其进行为期2年的随访,随访内容包括院外生存情况、脑钠肽(brain natriuretic peptide,BNP)、肌钙蛋白(cTn),尤其关注院外死亡患者出院前24h动态SBP监测情况。结果 3组生存率差异有统计学意义(P<0.05);3组出院后2年内BNP水平组间差异无统计学意义(P>0.05),时点间、组间·时点间交互作用差异有统计学意义(P<0.05),其中A组上升明显(P<0.05);cTn随访阳性情况,出院3个月时A组与B组阳性例数多于C组,出院6个月时A组多于B、C组,出院1、2年时A组多于B、C组且B组多于C组,差异均有统计学意义(P<0.05);随访2年内事件组25例(死亡)与非事件组9例(生存)出院前24h动态SBP水平差异有统计学意义(P<0.05),事件组出院前SBP水平显著降低(P<0.05)。结论SBP可作为老龄患者出院时有效判断预后的指标,临床医生对于SBP较低的心力衰竭患者应采取有效对策。更多还原

【Abstract】 Objective To investigate the relationship between prognosis and systolic blood pressure(SBP)of elder patients with heart failure.Methods Clinical datas of 35 patients with heart failure from Nov.2009 to Nov.2014 were retrospectively nanlyzed.According to the mean systolic blood pressure,34(1 patient lost)patients were divided into group A(SBP<100mmHg),group B(SBP 100-140 mmHg),group C(SBP>140 mmHg).The clinical statistics such as the survive time,BNP,cardiac troponin(cTn)and especially the 24 hour ambulatory blood pressure statistics of the patiens died were collected in two years.Results Survival rate of elderly patients among different SBP showed significant difference(P<0.05);Three groups of elderly patients within 2years after hospital discharge showed difference between time and the point of interaction(P>0.05)but no differences between groups.CTn positive rate was statistically significant difference among the 3groups(P<0.05).The cTn positive rate in group A and the group C were higher than those in group C at 3months.The cTn positive rate in group A were higher than those in group B and the group C at 6months.The cTn positive rate in group A were higher than those in group B and the group C at 1to 2years,and group A were higher than those in group B(P<0.05).Within 2years of follow-up,25patients(death)in the event group and 9patients(survival)in the non event group had significant difference in the dynamic SBP level 24 hbefore discharged from hospital(P<0.05).The event group had lower dynamic SBP than the survival group(P<0.05).Conclusion SBP can be used as an index to judge the prognosis of elderly patients discharged from hospital.Clinicians should take effective measures for patients with SBP with lower heart failure.更多还原