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功能衰竭和心力衰竭:从前性队列研究的预后和治疗影响
Finlay A McAlister1, Justin Ezekowitz, Marcello Tonelli
1Division of General Internal Medicine, University of Alberta, Edmonton, Canada. Finlay.McAlister@ualberta.ca
Circulation
|February 11, 2004
概括
功能衰竭在心力衰竭患者中很常见,并影响存活率. ACE 抑制剂和β 阻断剂提供类似的死亡益处,无论功能如何,即使在功能不良的人群中也是如此.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
背景情况:
- 功能不全是心力衰竭管理中的一个重要问题.
- 它的流行程度和对治疗疗效的影响尚未完全理解.
研究的目的:
- 为了调查心力衰竭患者功能不全的患病率.
- 为了确定功能的预后意义.
- 评估功能衰竭对ACE抑制剂和β抑制剂的益处的影响.
主要方法:
- 分析了754名心力衰竭患者的前性队列.
- 基线测量包括射出分数,血清肌素和体重.
- 使用Cockcroft-Gault方程进行评估的功能.
主要成果:
- 16%的患者的肌素清除值<或=30毫升/分钟;40%的患者的清除值在30-59毫升/分钟之间.
- 功能是生存的显著独立预后因素 (P=0.002).
- ACE 抑制剂和β 抑制剂在患有和没有功能不全的患者中显示出类似的死亡率降低.
结论:
- 在心力衰竭中,功能不全比以前认为的更为普遍.
- 它是缩和腹功能障碍的独立预后因素.
- ACE 抑制剂和β 阻断剂在不同程度的功能中提供可比的生存益处.
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