老年糖尿病患者合并急性心力衰竭时伴急性肾损伤的发生率及预后分析

摘要

目的:分析老年糖尿病患者合并急性心力衰竭时伴急性肾损伤(AKI)的发生率及其短期预后.方法:选取107例老年糖尿病合并急性心力衰竭患者作为观察组, 同期老年非糖尿病合并急性心力衰竭患者79例作为对照组,收集2组患者的病史资料、血尿素氮、肌酐、左室射血分数(LVEF)、血浆N末端B型脑肽前体(NT-proBNP)等指标,观察2组患者住院期间AKI的发生率,院内病死率和平均住院时间.6个月时随访心血管事件发生率及病死率.按院内是否发生AKI进行组内分组,了解亚组间病死率的差异.结果:观察组患者的AKI发生率、平均住院时间及院内病死率高于对照组(均P<0.05);观察组患者60d心血管事件发生率高于对照组 (P<0.05);发生院内AKI的患者病死率明显升高(P<0.05).结论:老年糖尿病患者合并急性心力衰竭时伴发的AKI及院外心血管事件发生率高,并且,发生AKI的患者病死率更高.%Objective: To analyze the morbidity of acute kidney injury (AKI) in the aged diabetic mellitus (DM) with acute heart failure, and the short-term prognosis.Method: 107 aged DN with acute heart failure served as observation group, and 79 aged non-DM with acute heart failure at the same period as control group.The clinical data, BUN, CRE, LVEF and NT-proBNP levels were recorded when admission.The AKI morbidity, mortality and average hospital stay were observed.The incidence of cardiovascular events was followed up at 6th day.The differences in mortality between the AKI subgroup and non-AKI subgroup were compared.Results: The morbidity and mortality of AKI were obviously higher, and the hospital stay was significantly longer in the observation group than in the control group (all P<0.05).The incidence of cardiovascular events at 60th day was higher in observation group than in control group (P<0.05).Mortality of AKI patients as higher in both two groups (P<0.05).Conclusion: The morbidity of AKI and out-hospital cardiovascular events was higher in aged DM with acute heart failure.Moreover, the mortality of AKI patients was higher.