Tang Qing, Hua Qi
Department of Cardiology, Xuanwu Hospital, Capital Medical University, China.
Intern Med. 2011;50(9):969-74. doi: 10.2169/internalmedicine.50.4703. Epub 2011 May 1.
This study was investigated to determine the relationship between hyponatremia and in-hospital outcomes in Chinese patients with ST-elevation myocardial infarction.
Plasma sodium concentration was obtained in all patients on admission and analyzed as hyponatremia versus normalnatremia. The relationships between hyponatremia and in-hospital mortality as well as heart failure were assessed.
Of 1,620 patients, 212 (13.1%) patients had hyponatremia on presentation (sodium <135 mmol/L). Patients with hyponatremia had higher rates of in-hospital mortality (13.7% vs. 7.3%, p=0.002) and heart failure (30.2% vs. 18%, p<0.001). Patients with a sodium level of <130 mmol/L had an adverse event rate of 22.9% versus 11.0% in patients with a sodium level of 130 to 135 mmol/L (p=0.034). In multivariate logistic regression, hyponatremia was independently correlated with in-hospital mortality (OR: 1.77, 95% CI: 1.02-3.06, p=0.042) and heart failure (OR: 1.61, 95% CI: 1.06-2.43, p=0.025).
Hyponatremia is independently associated with in-hospital adverse outcomes in Chinese patients with acute ST-elevation myocardial infarction, and the risk of in-hospital mortality was increased with the severity of hyponatremia.
本研究旨在确定中国ST段抬高型心肌梗死患者低钠血症与院内结局之间的关系。
所有患者入院时均测定血浆钠浓度，并分析低钠血症与血钠正常情况。评估低钠血症与院内死亡率以及心力衰竭之间的关系。
在1620例患者中，212例（13.1%）患者入院时存在低钠血症（血钠<135 mmol/L）。低钠血症患者的院内死亡率（13.7%对7.3%，p=0.002）和心力衰竭发生率（30.2%对18%，p<0.001）更高。血钠水平<130 mmol/L的患者不良事件发生率为22.9%，而血钠水平为130至135 mmol/L的患者为11.0%（p=0.034）。在多因素逻辑回归分析中，低钠血症与院内死亡率（比值比：1.77，95%置信区间：1.02-3.06，p=0.042）和心力衰竭（比值比：1.61，95%置信区间：1.06-2.43，p=0.025）独立相关。
在中国急性ST段抬高型心肌梗死患者中，低钠血症与院内不良结局独立相关，且院内死亡风险随低钠血症严重程度增加而升高。
