| 胡伟伟,臧宝赫,徐猛,等.血清晶体渗透压与 ICU中急性心力衰竭病人的院内 28 d全因死亡 U型关系的研究[J].安徽医药,2026,30(6):1144-1148. |
| 血清晶体渗透压与 ICU中急性心力衰竭病人的院内 28 d全因死亡 U型关系的研究 |
| U-shaped relationship between serum osmolarity and 28-day in-hospital all-cause mortality in patients with acute heart failure in the intensive care unit |
| |
| DOI：10.3969/j.issn.1009-6469.2026.06.017 |
| 中文关键词: 心力衰竭 血清晶体渗透压 重症监护室 院内28 d全因死亡 U型关系 |
| 英文关键词: Heart failure Serum osmolarity Intensive care unit |
| 基金项目:徐州市卫生健康委科技项目( XWKYHT20230074) |
|
| 摘要点击次数: 49 |
| 全文下载次数: 17 |
| 中文摘要: |
| 目的探讨血清晶体渗透压与重症监护室( ICU)中的急性心力衰竭( AHF)病人院内 28 d全因死亡的关系。方法回顾性收集 2014年 6月至 2022年 6月在徐州医科大学附属医院 ICU住院的 994例 AHF病人，根据院内病人住 ICU后 28 d内是否发生死亡分成院内存活组( n=831)和院内死亡组( n=163)研究变量为血清晶体渗透压。应用限制性立方图、 logistic回归和亚组分析来探讨血清晶体渗透压与院内 28 d全因死亡率的关，系。结果相较于院内存活组，院内死亡组病人的年龄较大( P<0.05)，收缩压和舒张压较低( P<0.05)，心率和呼吸频率( RR)较快(P<0.05)，且合并急性心肌梗死、呼吸衰竭和心室颤动的占比更高(P<0.05)。此外，白细胞、尿素氮、肌酐、血糖、 C反应蛋白(CRP)、血乳酸、 N末端脑钠肽前体( NT-proBNP)和血清晶体渗透压［( 309.23±14.80)mmol/L比( 305.78±12.29)mmol/L］水平较高( P<0.05)，白蛋白水平较低( P<0.05)。入院序贯器官衰竭评估(SOFA)评分和简明急性生理学评分 Ⅱ(SAPSⅡ)评分较高( P<0.05)且利尿剂和血管活性药物使用比例高( P<0.05)。此外，血清晶体渗透压与 ICU中 AHF病人的院内 28 d死亡率呈 U型关系(性 P=0.020)最佳拐点值为 304.822 mmol/L。在多因素 logistic回归分析中，血清晶体渗透是院内 28 d全因死亡率的危险性因素［ OR=1.025%CI:(1.00，1.03)，P=0.044］。亚组分析显示，血清晶体渗透压与院内 28 d全因死亡的其他相关因素间无显著相互作用( P>0.05)。结论在 ICU中，血清晶体渗透压与 AHF病人住院 28 d内发生全因死亡呈 U型关系，最佳拐点值为 304.822 mmol/L。 |
| 英文摘要: |
| Objective To investigate the relationship between serum osmolarity and 28-day in-hospital all-cause mortality in patients with acute heart failure (AHF) in the intensive care unit (ICU).Methods A total of 994 patients with AHF admitted to the ICU of theAffiliated Hospital of Xuzhou Medical University from June 2014 to June 2022 were retrospectively enrolled. They were categorized in.to an in-hospital survival group (n=831) and an in-hospital mortality group (n=163) based on whether death occurred within 28 days af.ter ICU admission. The exposure variable was serum osmolarity. Restricted cubic splines (RCS), logistic regression, and subgroup anal.ysis were used to assess the relationship between serum osmolarity and 28-day in-hospital all-cause mortality in AHF patient in the ICU.Results Compared with the survival group, the patients in the death group were older, had lower systolic and diastolic blood pres.sure, faster heart rate and respiratory rate, and were more likely to present with acute myocardial infarction, respiratory failure, and ven.tricular fibrillation. In addition, levels of leukocytes, blood urea nitrogen, creatinine, blood glucose, CRP, blood lactate, NT-proBNP, and serum osmolarity [(309.23±14.80) mmol/L vs. (305.78±12.29) mmol/L] were higher, and albumin levels were lower. Admission SO.FA scores and SAPS Ⅱ scores were higher, and they had higher rates of diuretics and vasoactive drug use (P<0.05). Furthermore, there was a U-shaped relationship between serum osmolarity and 28-day in-hospital all-cause mortality among AHF patients in the ICU (P for nonlinearity=0.020), and the optimal inflection point was 304.822 mmol/L. In multivariate logistic regression, serum osmolarity was arisk factor for 28-day in-hospital all-cause mortality [OR=1.02, 95%CI: (1.00, 1.03), P=0.044]. Subgroup analysis showed that therewas no significant interaction between serum osmolarity level and other relevant factors of all-cause mortality (P>0.05). Conclusion There was a U-shaped relationship between serum osmolarity and 28-day in-hospital all-cause mortality among AHF patients in the ICU, with an optimal inflection point of 304.822 mmol/L. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
