[低钠血症对急性心肌梗死患者的预后价值]

[The prognostic value of hyponatremia in patients with acute myocardial infarction].

作者信息

Wang Lan-feng, Li Zhu-qin, Tang Qing, Xu Dan, Sun Xin-yong, Li Wei-min, Fu Shi-ying

机构信息

Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2006 Mar;34(3):243-6.

PMID:16630460

Abstract

OBJECTIVE

To evaluate the prognostic significance of hyponatremia in patients with AMI.

METHODS

The study population consisted of 670 patients with AMI in coronary care unit in our hospital from January 2003 to December 2004. The patients were designed into three groups according to serum sodium concentration within twenty four to forty eight hours following the onset of AMI: Group A. Na(+) > or = 135 mmol/L; Group B. Na(+) 120-135 mmol/L; Group C. Na(+) < or = 120 mmol/L. The data of myocardial enzymes, myocardial infarction size, heart function and inhospital mortality were analyzed retrospectively.

RESULTS

The inhospital mortality of each group: group A was 7.6% (17/225), group B was 8.1% (34/421), group C was 33.3% (8/24). The difference between group C and group B or group A was significant. The P value was little than 0.05. 2. Activities of serum creatine phosphatase kinase and serum creatine phosphatase kinase isoenzymes and myocardial infarction sizes in each group were different (P < 0.05). 3. 59 cases of all died and 611 cases of all recovered in duration of hospital stay. Serum sodium concentrations of the recovered group were (133.00 +/- 5.25) mmol/L, and that of the died group were (122.00 +/- 7.25) mmol/L (P < 0.01). 4. In a multivariate logistic regression analysis, hyponatremia was associated with 30-day mortality in patients with AMI. In analysis of the association between the degree of hyponatremia and outcome, we observed that the risk of 30-day mortality increased with the severity of hyponatremia.

CONCLUSION

Hyponatremia may be one of the important markers that predict a worse prognosis in patients with AMI.

摘要

目的

评估急性心肌梗死（AMI）患者低钠血症的预后意义。

方法

研究对象为2003年1月至2004年12月在我院冠心病监护病房的670例AMI患者。根据AMI发病后24至48小时内的血清钠浓度将患者分为三组：A组，Na(+)≥135 mmol/L；B组，Na(+)为120 - 135 mmol/L；C组，Na(+)≤120 mmol/L。回顾性分析心肌酶、心肌梗死面积、心功能及住院死亡率等数据。

结果

各组住院死亡率：A组为7.6%（17/225），B组为8.1%（34/421），C组为33.3%（8/24）。C组与B组或A组之间差异有统计学意义，P值小于0.05。2. 各组血清肌酸磷酸激酶及其同工酶活性和心肌梗死面积不同（P < 0.05）。3. 住院期间共59例死亡，611例康复。康复组血清钠浓度为（133.00±5.25）mmol/L，死亡组为（122.00±7.25）mmol/L（P < 0.01）。4. 多因素logistic回归分析显示，低钠血症与AMI患者30天死亡率相关。在分析低钠血症程度与预后的关系时，我们观察到30天死亡率风险随低钠血症严重程度增加而升高。