摘要
目的:分析慢性心力衰竭患者抗凝治疗的相关因素。方法:纳入河南大学第一附属医院2019年1月至2022年1月收治的慢性心力衰竭患者196例进行研究,回顾性分析所有患者的临床资料和随访资料,依据其是否进行抗凝治疗分为抗凝组(n=101)和未抗凝组(n=95),比较两组患者的各项资料,单因素和Logistic多因素分析慢性心力衰竭患者抗凝治疗的相关因素,并比较两组患者的预后情况。结果:未抗凝组患者的年龄高于抗凝组,大学及以下教育水平占比、血管疾病占比、贫血占比、明尼苏达心力衰竭生活质量评分(minnesota living with heart failure questionnaire,MLHFQ)评分≥40分占比、血红蛋白<110g/L占比、左心房内径<40mm占比、长期就诊医院距离≥5km占比、使用抗血小板治疗占比、使用地高辛占比均高于抗凝组,慢性心力衰竭史占比、血栓栓塞史占比、使用β受体阻滞剂占比均低于抗凝组,病史短于抗凝组,TG水平低于抗凝组,差异有统计学意义(P<0.05)。以慢性心力衰竭患者未抗凝治疗为应变量,赋值1=未抗凝治疗,0=抗凝治疗。各因素均来源于表1内P<0.05的指标,取所有样本的中位值为自变量,建立非条件Logistic回归模型,无慢性心力衰竭史、无血栓栓塞史、MLHFQ评分<40分、抗血小板治疗为慢性心力衰竭患者未抗凝治疗的相关因素(P<0.05)。未抗凝组患者的美国纽约心脏病学会分级(New York heart association,NYHA)、N端脑钠肽前体(N-terminal pro-B-type natriuretic peptide,NT-proBNP)、MLHFQ评分水平高于抗凝组,左室射血分数(left ventricular ejection fraction,LVEF)、6分钟步行距离(6-minute walking test,6-MWT)水平低于抗凝组,差异有统计学意义(P<0.05)。结论:慢性心力衰竭患者抗凝治疗率相对较低,应当对存在影响抗凝治疗相关因素的患者加强管理及相关教育,提升抗凝治疗率。
Objective:To analyze the relevant factors of anticoagulation therapy in patients with chronic heart failure.Methods:A study was conducted on 196 patients with chronic heart failure admitted to the First Affiliated Hospital of Henan University from January 2019 to January 2022.Clinical and follow-up data of all patients were retrospectively analyzed,and they were divided into anticoagulant group(n=101)and non anticoagulant group(n=95)based on whether they received anticoagulant treatment.The data of the two groups of patients were compared,and the relevant factors of anticoagulant treatment in patients with chronic heart failure were analyzed using univariate and logistic multivariate methods,And compare the prognosis of the two groups of patients.Results:The age of patients in the non anticoagulant group was higher than that in the anticoagulant group,and the proportion of college education and below,vascular disease,anemia,Minnesota Heart Failure Quality of Life Score(MLHFQ)score≥40,hemoglobin<110g/L,left atrial diameter<40mm,long-term hospital distance≥5km,use of antiplatelet therapy,and use of digoxin were all higher than those in the anticoagulant group,Proportion of chronic heart failure history,proportion of thromboembolism history,and usageβThe proportion of receptor blockers was lower than that of the anticoagulant group,and the medical history was shorter than that of the anticoagulant group.The TG level was lower than that of the anticoagulant group,and the difference was statistically significant(P<0.05).Taking chronic heart failure patients without anticoagulation treatment as the dependent variable,assign values of 1=no anticoagulation treatment,and 0=anticoagulation treatment.All factors were derived from the indicators P<0.05 in Table 1,and the median values of all samples were taken as independent variables to establish an unconditional logistic regression model.The results showed that history of chronic heart failure,history of thromboembolism,MLHFQ score≥40 points,and antiplatelet therapy were related factors for patients with chronic heart failure who did not receive anticoagulant treatment(P<0.05).The New York Heart Association classification(NYHA),N-terminal proBNP,and MLHFQ scores of patients in the non anticoagulant group were higher than those in the anticoagulant group,while the left ventricular ejection fraction(LVEF)and 6-minute walking distance(6-MWT)levels were lower than those in the anticoagulant group,with statistically significant differences(P<0.05).Conclusion:The anticoagulation treatment rate of patients with chronic heart failure is relatively low,and it is necessary to strengthen monitoring and relevant education for patients with factors that affect anticoagulation treatment,in order to promote the improvement of anticoagulation treatment rate.
作者
王志谦
孟祥旭
WANG Zhiqian;MENG Xiangxu(Department of Cardiovascular Medicine,First Affiliated Hospital of Henan University,Kaifeng 475000,China)
出处
《黑龙江医药科学》
2024年第3期53-56,共4页
Heilongjiang Medicine and Pharmacy
基金
2022度河南省医学科技攻关项目联合共建项目,编号:LHGJ20220645。
关键词
慢性心力衰竭
抗凝
因素
预后
chronic heart failure
anticoagulant
factors
prognosis
作者简介
王志谦(1992-),男,河南开封人,硕士,主治医师。
