目的：观察慢性心力衰竭（chronic heart failure ，CHF）住院患者肾功能恶化的发生率和临床特点，并探讨CHF住院患者肾功能恶化的危险因素。方法：采用病例对照研究的方法，以住院期间血肌酐（Scr）的变化值判断CHF患者的肾功能是否恶化；采用logistic回归方程分析CHF患者肾功能恶化的独立危险因素。结果：中、重度CHF住院患者肾功能不全的发生率为38．21％，肾功能恶化的发生率为22．76％。贫血[血红蛋白（Hb）＜90 g／L ，P＝0．042]、低钠血症（Na＋＜135 mmol／L ，P＝0．019）、肾功能不全[肾小球滤过率（GFR）＜60 mL／（min ·1．73 m2），P＝0．001]与肾功能恶化的发生独立相关。结论：肾功能不全、贫血和低钠血症是CHF患者肾功能恶化的重要危险因素。%Objective:To observe the incidence rate and the clinical characteristics of worsening renal function in hospitalized patients with chronic heart failure (CHF) ,and explore the risk factors associated with worsening renal function in hospitalized CHF patients .Methods:By using case‐control method ,the changed value of serum creatinine (Scr) during hospitalization was evaluated to judge whether the renal function of CHF patients deteriorated .And the independent risk factors for worsening renal function in CHF patients were analyzed by logistic regression equation .Results:The incidence of renal insufficiency in hospitalized patients with medium and severe CHF was 38 .21% ,while the incidence of worsening renal function was 22 .76% . Anemia (Hb<90 g/L , P=0 .042) ,hyponatremia (Na+ <135 mmol/L , P=0 .019) ,and renal function insufficiency (GFR<60 mL/[min · 1 .73 m2 ] ,P=0 .001) was independently associated with the deterioration of renal function .Conclusions:The renal insufficiency ,anemia ,and hyponatremia are important risk factors for worsening renal function in CHF patients .
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