【摘要】 目的探讨DKD患者急性失代偿心力衰竭(ADHF)疗效的危险因素。方法选取DKD合并ADHF患者302例,分为无效组94例(入院1周后NT-proBNP较入院当日下降幅度<30%)及有效组208例(入院1周后NT-proBNP较入院当日下降幅度≥30%)。比较两组一般资料及生化指标,Pearson相关分析NT-proBNP与其他指标的相关性,Logistic回归分析DKD患者ADHF短期预后的影响因素。结果与无效组比较,有效组血脂异常史、重组人脑利钠肽(rhBNP)使用率升高(P<0.05或P<0.01),LDL-C、C-RP、血P、24 h尿蛋白(24 h UP)降低(P<0.05或P<0.01)。Pearson相关分析显示,NT-proBNP与LDL-C、24 h UP、C-RP呈负相关(P<0.05)。Logistic回归分析显示,LDL-C、C-RP、24 hUP及rhBNP使用是DKD患者ADHF住院疗效的影响因素。结论 LDL-C、C-RP、24 hUP的升高预示DKD患者ADHF住院疗效欠佳,预后不良;应用rhBNP可改善DKD合并ADHF患者的临床结局。更多还原

【Abstract】 Objective To investigate the risk factors for the efficacy of acute decompensated heart failure(ADHF)in patients with diabetic kidney diseases(DKD).Methods A total of 302 patients with DKD combined with ADHF were selected and divided into ineffective group(94 cases)and effective group(208 cases)(NT-pro BNP decreased by less than 30% on one week after admission compared with admission day). Comparison of general data and biochemical indexes between the two groups,Pearson correlation analysis of the correlation between each index and NT-pro BNP,Logistic regression analysis of influencing factors of short-term prognosis of ADHF in DKD patients.Results Compared with the ineffective group,the history of dyslipidemia and the utilization rate of recombinant human brain natriuretic peptide in the effective group increased(P<0. 05 or P<0. 01),while LDL-C,C-RP,blood P and 24 h UP decreased(P<0. 05 or P<0. 01). Pearson correlation analysis showed that LDL-C,24 h UP and C-RP were negatively correlated with the short-term prognosis of ADHF(P<0. 05). Logistic regression analysis showed that LDL-C,C-RP,24 h UP and recombinant human brain natriuretic peptide were the influencing factors of ADHF hospitalization effect in DKD patients.Conclusion The increase of LDL-C,C-RP and 24 h UP indicates that the hospitalization effect of ADHF in DKD patients is not good enough and the poor prognosis. The application of recombinant human brain natriuretic peptide can improve the clinical outcome of DKD patients with ADHF.更多还原