某三甲医院冠心病重症监护室住院患者心功能现状及影响因素分析

doi:10.3760/cma.j.cn441417-20241021-15010

摘要/Abstract

摘要：

目的　探究某三甲医院冠心病重症监护室（CCU）住院患者心功能现状，分析影响心功能恢复的因素。方法　回顾性分析2022年6月至2024年6月阜外华中心血管病医院CCU 200例住院患者。根据纽约心功能分级，Ⅰ～Ⅱ级为心功能良好组，共56例（28.00%），Ⅲ～Ⅳ级为心功能不良组，共144例（72.00%）。对比两组患者一般资料、实验室指标以及心功能指标，采用logistic回归分析冠心病患者心功能恢复的影响因素。采用独立样本t检验、χ²检验进行统计学分析。结果　心功能良好组男27例，女29例，年龄（62.42±5.46）岁；心功能不良组男75例，女69例，年龄（62.58±5.32）岁。两组患者合并高血压、高血脂、糖尿病、脑血管疾病比例，CCU住院时长、近1年内住院次数、伴有心衰、美国东部肿瘤协作组（Eastern Cooperative Oncology Group，ECOG）体力状态评分差异均有统计学意义（均P<0.05）；性别、年龄、体重指数差异均无统计学意义（均P>0.05）。两组患者低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）、游离三碘甲状腺原氨酸（free triiodothyronine，FT3）、促甲状腺激素（thyroid-stimulating hormone，TSH）水平差异均有统计学意义（均P<0.05）；总胆固醇（total cholesterol，TC）、甘油三酯（triglyceride，TG）、红细胞计数（red blood count，RBC）、白细胞计数（white blood count，WBC）、血小板计数（platelet，PLT）、游离四碘甲状腺原氨酸（free thyroxine，FT4）水平差异均无统计学意义（均P>0.05）。两组左心房内径（left atrial diameter，LAD）、左心室内径（left ventricular diameter，LVD）、右心房内径（right atrial diameter，RAD）、右心室内径（right ventricular diameter，RVD）差异均有统计学意义（均P<0.05）。logistic回归分析表明，合并高血压、CCU住院时长、近1年内住院次数、伴有心衰、LAD、LVD、RAD、RVD是心功能恢复的独立危险因素（均P<0.05）。结论　合并高血压、CCU住院时长、近1年内住院次数、伴有心衰、LAD、LVD、RAD、RVD水平与CCU住院患者心功能呈正相关，是心功能恢复的独立危险因素，掌握冠心病独立危险因素对治疗该疾病有重要指导作用。

关键词:

冠心病, 心功能, 危险因素

Abstract:

Objective　To investigate the current status of cardiac function among inpatients in the coronary care unit (CCU) of a tertiary hospital, and to analyze the influencing factors of cardiac function recovery. Methods　A retrospective analysis was conducted on 200 inpatients admitted to the CCU of Fuwai Central China Cardiovascular Hospital from June 2022 to June 2024. According to the New York cardiac function classification, patients with grade I to II were classified as a good cardiac function group, a total of 56 cases (28.00%); patients with grade III to IV were classified as a poor cardiac function group, a total of 144 cases (72.00%). The general information, laboratory indicators, and cardiac function indicators of the two groups were compared. Logistic regression analysis was used to explore the influencing factors of cardiac function recovery in patients with coronary heart disease. Statistical analysis was conducted using independent sample t test and χ² test. Results　In the good cardiac function group, there were 27 males and 29 females, with an age of (62.42±5.46) years old; in the poor cardiac function group, there were 75 males and 69 females, with an age of (62.58±5.32) years old. There were statistically significant differences between the two groups in terms of the proportions of hypertension, hyperlipidemia, diabetes, and cerebrovascular diseases, the length of stay in CCU, the number of hospitalizations in the last 1 year, the presence of heart failure, and the Eastern Cooperative Oncology Group (ECOG) performance status score (all P<0.05); while there was no statistically significant difference in terms of gender, age, or body mass index (all P>0.05). There were statistically significant differences in the levels of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH) between the two groups (all P<0.05); while there was no statistically significant difference in the level of total cholesterol (TC), triglycerides (TG), red blood count (RBC), white blood count (WBC), platelet count (PLT), or free thyroxine (FT4) (all P>0.05). There were statistically significant differences in the left atrial diameter (LAD), left ventricular diameter (LVD), right atrial diameter (RAD), and right ventricular diameter (RVD) between the two groups (all P<0.05). Logistic regression analysis indicated that hypertension, length of stay in CCU, number of hospitalizations in the last 1 year, presence of heart failure, LAD, LVD, RAD, and RVD were independent risk factors for cardiac function recovery (all P<0.05). Conclusions　Hypertension, length of stay in CCU, number of hospitalizations in the last 1 year, presence of heart failure, LAD, LVD, RAD, and RVD are positively correlated with the cardiac function among patients hospitalized in the CCU, which are independent risk factors affecting the recovery of cardiac function. The mastery of the independent risk factors of coronary heart disease has an important guiding role in the treatment of this disease.

Key words:

Coronary heart disease, Heart function, Risk factors

郝超凡叶发民.

某三甲医院冠心病重症监护室住院患者心功能现状及影响因素分析 [J]. 国际医药卫生导报, 2025, 31(15): 2515-2519.

Hao Chaofan, Ye Famin.

Analysis of the current status of cardiac function and influencing factors among inpatients in the coronary care unit of a tertiary hospital [J]. International Medicine and Health Guidance News, 2025, 31(15): 2515-2519.

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