| BackgroudChronic heart failure (CHF, chronic heart failure) is a complex clinical syndrome, various heart diseases are likely outcome of the disease and death. Although the disease is complicated, due to the cardiac structure and function abnormalities, ultimately affect ventricular filling and ejection ability. Currently, studies of cardiorenal syndrome are popular, some achievements have been done. Cardiorenal syndrome type 2 is renal injury caused by chronic heart diseases. Therefore, we adopted a retrospective study, using the computer and statistical software, to analysis the data of the patient once lived in hospital with chronic heart failure.ObjectiveTo explore the prognostic value of renal function in chronic heart failure and the relationship between renal function and syndrome elements.MethodsWe selected 409 cases of CHF patients hospitalized in Guang’anmen HospitaL,China Academy of Chinese Medical Sciences between January 2006 and June 2014. Follow-up date of these cases is within the range of 30-730 days. Hospital medical records were colleted, and Excel were used to create a database. SPSS software were used to make the ROC curve and find out the cutting point, to divide the cases into two group.Kaplan-meier survival curves, spearman correlation analysis and other statistical work, were done.Result1. Results of Kaplan-meier survival curve analysis(1) The area under the ROC curve of serum creatinine and prognosis is0.605, P= 0.001<0.01, The Curve positions of the first two groups are significantly higher than that of the third group, Log-rank= 13.337, P<0.01;(2) The area under the ROC curve of eGFR is 0.462<0.5;(3) The area under the ROC curve of serum urea nitrogen and prognosis is 0.678, P <0.01,The Curve position of the first groups is significantly higher than that of the second group, Log-rank= 33.160, P<0.01;(4) The area under the ROC curve of serum uric acid and prognosis is 0.568, P= 0.033, The Curve position of the first groups is significantly higher than that of the second group, Log-rank= 13.369, P<0.01.2. Results of Spearman correlation analysis(1) Results of renal function markers and prognostic1) There is a correlation between serum creatinine and death, The correlation coefficient is 0.164, P= 0.00 <0.01;2) There is a correlation between serum urea nitrogen and death, The correlation coefficient is 0.277, p= 0.00<0.01;3) There is a correlation between serum uric acid and death, The correlation coefficient is 0.120, p= 0.021<0.05;4) There is no significant correlation between eGFR and prognosis.(2) Results of renal function markers and cardiac function1) There are positive correlations among renal function markers and N-proBNP: The correlation coefficient of serum creatinine and N-proBNP is 0.195, P= 0.001<0.01,; The correlation coefficient serum urea nitrogen and N-proBNP is 0.430, p= 0.000<0.01; The correlation coefficient of serum uric acid and N-proBNP is 0.289, p= 0.033<0.05.2) There is no significant correlation between eGFR with N-proBNP;3) There are negative correlations among renal function markers and LVEF The correlation coefficient of serum urea nitrogen and LVEF is-0.134, p= 0.010<0.05 statistically significant; The correlation coefficient of serum uric acid and LVEF is-0.183, p= 0.000<0.01, statistically significant;The correlation coefficient of eGFR acid and LVEF is-0.143, p= 0.006<0.01, statistically significant.(3) Results of renal function markers and syndrome elements1) There is a correlation between Qi or Yang deficiency and death, the correlation coefficient is 0.173, P= 0.00<0.01;2) There is a positive correlation between serum uric acid and Yang deficiency, the correlation coefficient is 0.137, P= 0.011<0.05;3) There is a negative correlation between eGFR and Qi deficiency, the correlation coefficient is-0.110, P= 0.032<0.05.4) There is positive correlation between serum creatinine and Qi or Yang deficiency, the correlation coefficient is 0.135, P= 0.009<0.01;There is a n positive correlation between serum uric acid and Qi or Yang deficiency, the correlation coefficient is 0.148, P= 0.004<0.01;There is a negative correlation between eGFR and Qi or Yang deficiency, the correlation coefficient is-0.133, P= 0.009<0.01.ConclusionThe level of kidney function in patients with CHF for prognosis has certain influence, in the commonly used evaluation indicators of renal function, serum creatinine, blood urea nitrogen and serum uric acid for the prognosis effect is more remarkable, as the clinical evaluation of CRS state index. Qi deficiency is associated with poor prognosis, serum uric acid is associated with yang deficiency, eGFR is negatively correlated with Qi (or Yang) deficiency, serum creatinine and serum uric acid are positive correlated with Qi or Yang deficiency, for the guidance of clinical treatment has a certain significance. |
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