nghiên cứu một số tiên lượng ở bệnh nhân suy tim mạn đợt cấp

498

NGHIÊN CU
MT S YU T NG  BNH NHÂN SUY TIM MT CP

Hunh Châu Tun
1
n
2
, Hu
3
.

1
p Vnh long,
2
c Cn T
3
c Hu


  
 



 



trung bình 36,21±10,81%.    hút

            

+

 
 

SUMMARY
STUDY OF SOME PREDICTED FACTORS IN ACUTE DECOMPENSATED
PHASE OF THE HEART FAILURE PATIENTS .
Aim of study: to evaluate some predicted factors in acute decompensated phase of the heart
failure patients.
Patients & methods: All the chronic heart failure patients over 18 years olds in the
department of cardiology of Cantho hospital from the October 2009 to Mars 2010 were included
were included in this study. The Framingham criteria and NYHA degree was applied for the
diagnosis of heart failure.
Results: there were 172 patients including 99 female persons with the prevalence of 57,56%.
The average age was 71,01 ± 13,62 yrs. The underlying causes were ischemic heart disease and
arterial hypertension with the prevelance of 36,6% and 33,1% respectively. The natremia
concentration was under 135 mmol/l (48, 8%). The mortality rate was 20/172 was 11,6%. The
death cases had the low concentration of natremia ( 8,1%), the mean EF indice 36,21±10,81%.
There are the significant correlation between the mortality rate with tachycardia ( p< 0.001), the
NYHA degree of heart failure ( p<0,001), the low EF indice ( p< 0,05), the low concentration of
natremia (p< 0,001).
Conclusion: it must evaluate the outcome of the acute phase of chronic heart failure by
based upon the factors such as heart rate, low blood pressure, the degree of heart failure, the
natremia anf EF indice.





                   

-



499

1.   





 






- 
- 
- 
 
- 


- 

- 
- 

- 

2.5
m SPSS 12.0.1, Excel
2003.








99
57,56%
Nam
73
42,44%

172
100%





<40

06
3,5%
40-60
35
20,3%
>60
131
76,2%

172
100%



n
%

Có
66
38,4%
Không
106
61,6%

Có
82
47,7%
Không
90
52,3%

500

n
%

Có
39
22,7%
Không
133
77,3%

Có
24
14%
Không
148
86%

Có
50
29,1%
Không
122
70,9%

Có
14
8,1%
Không

158
91,9%

Có
39
22,7%
Không
133
77,3%

Có
4
2,3%
Không
168
97,7%


Có
0
0%
Không
172
100%
 


 





I
0
0%
II
15
8,7%
III
145
84,3%
IV
12
7%

172
100%
1,3%



X±SD
Hct
33,80±5,82
Hb
11,74±1,97
Na
132,49±14,04
K
3,83±0,69


6,80±3,56
Creatinin
127,50±82,01
Cholesteron
4,36±0,98
Triglycerid
1,45±0,60
HDL
0,93±0,29
LDL
2,78±0,78

 


p<0,001
n
%
n
%
< 60
2
1,2
1
0,6
60-80
4
2,3
34

19,8
80-100
2
1,2
69
40,1
> 100
12
6,9
48
27,9

20
11,6
152
88,4

-
1)
501


-




+
/ máu
(mmol/L)



p<0,05
n
%
n
%
< 135
14
8,1
70
40,7
135-145
5
2,9
82
47,7
> 145
1
0,6
0
0

20
11,6
152
88,4


-145mEq/L





+
/ máu
(mmol/L)


p>0,05
n
%
n
%
< 3,5
5
2,9
56
32,6
3,5-5
13
7,6
89
51,7
> 5
2
1,2
7
4,1


20
11,6
152
88,4

 



p
n
%
n
%

Có
15
8,7
106
61,6
0,628
Không
5
2,9
46
26,7

Có
8
4,7

42
24,4
0,252
Không
12
7
110
64


Có
4
2,3
35
20,3
0,761
Không
16
9,3
117
68
                  

 







trái (EF)

BN xu
p<0,05
n
%
n
%

11
6,4
48
27,9
> 30%
9
5,2
104
60,5

20
11,6
152
88,4


                 
 (p>0,05)
502

HA



p<0,001
n
%
n
%
I
0
0
0
0
II
0
0
15
8,7
III
8
4,7
137
79,7
IV
12
7
0
0

20
11,6

152
88,4
             
 


1.



                

ãng 80-

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

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


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             


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                 
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






 tháng, 3 tháng, 6 tháng, 12 tháng


503
                 
   
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
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
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


 



 


Nh            
 
- IV
40-50% [13]
                 


ng


  
              rong máu cao > 145

135-

Qua khai thá







                    -
Va






tri máu.


Natri



504


máu (Natri








 
-2,32) [12]



-30,10; p<0,001) [11]


- 







               

 (p<0,05)
Trong siêu âm tim M-
- 


 


vi--2,02;
p=0,001) [4]


95%CI: 1,226-




 
- 


- 
 
- 
- 

- 
- 

505
- 


- 
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+
 
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- 
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máu
)


1. Suy tim-4
2. -428
3. -168
4. 
-40
5. Hóa sinh lâm sàng,

-114
6. 
--76
7. Hóa
sinh lâm sàng-160
8. Khu

-493
9. William T Abraham, Henry Krum (2007), Heart Failure, a practical approach to
treatment, McGraw-Hill Companies, pp.54
10. Braunwald, Heart Disease (2007), A text book of cardiovascular medicine, 8
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Saunders, An Imprint of Elsevier, 4(22)
11. Aronson D, Mittleman MA, Burger AJ (2004), Elevated blood urea nitrogen level as a
predictor of mortality in patients admitted for decompensated heart failure, 116(7):466-73)
12. Goldman, Ausiello (2004), Heart Failure: Management and Prognosis, Cecil Text book of
Medicine, 22
nd
edition, W B Sauders company, an Elsevier imprint
13. Michael H.Crawford (2002), Congestive Heart Failure, Current Diagnosis & Treament in
Cardiology, 2
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Ed, McGraw-Hill
14. Murray Longmore, lan B Wilkinson, Tom Turmezei, Chee Kay Cheung (2007),
Cardiovascular Medicine, Oxford Handbook of Clinical Medicine, 7
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15. Sales AL, Villacorta H, Reis L, Mesquita ET (2005), Anemia as a prognostic factor in a

population hospitalized due to decompensated heart failure, Arquivos Brasileiros de
Cardiologia, 84(3):237-240.
16. Mariell Jessup, William T.Abraham, Donald D.Casey (2009), ACCF/AHA Guidelines
for the Diagnosis and Management of Heart Failure in Adults, Circulation, 119; 1977-
2016
17. Eric J. Topol (2007), Global Pandemic of Heart Failure, Textbook of Cardiovascular
Medicine, 3
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