摘要
目的了解山西医科大学第二临床医学院慢性心力衰竭住院患者的病因构成、合并症和诊疗特点,比较不同射血分数心力衰竭患者的基线资料。方法收集2015-01-01~2018-07-31于我院心血管内科住院的慢性心力衰竭患者739例,回顾性分析患者的一般临床资料。结果本研究纳入的患者中男性401例(54.3%),女性338例(45.7%)。年龄为23-99岁,平均(66.7±14.5)岁。心力衰竭病因主要为冠心病269例(36.4%),其次为扩张型心肌病147例(19.9%)、高血压性心脏病114例(15.4%)、风湿性心脏病83例(11.2%)和其他126例(17.1%)。住院期间利尿剂、血管紧张素转换酶抑制剂/血管紧张素-Ⅱ受体拮抗剂(ACEI/ARB)、β受体阻滞剂、洋地黄类、醛固酮受体拮抗剂、血管扩张剂、钙离子拮抗剂、正性肌力药物的使用率分别为86.7%,65.8%,66.8%,37.6%,76.5%,75.0%,28.1%,49.3%。739例心力衰竭患者中射血分数减少性心衰(HFrEF)248例(33.6%),射血分数中间值的心衰(HFmrEF)111例(15.0%),射血分数保留性心衰(HFpEF)380例(51.4%)。与HFrEF组相比,HFmrEF组入院时收缩压更高、住院时间更长(P<0.05),以高血压性心脏病、风湿性心脏病多见,多合并胸腔积液,住院期间钙离子拮抗剂的使用率高(P<0.0167)。与HFpEF组相比,HFmrEF组患者以男性、有吸烟史、年龄≤34岁、NYHAⅣ级、扩心病、合并胸腔积液所占比例较高,利尿剂、ACEI/ARB、β受体阻滞剂、醛固酮受体拮抗剂使用率高(P<0.0167),入院时舒张压更高、住院时间长,BNP水平更高(P<0.05)。结论慢性心力衰竭的病因主要为冠心病、扩张型心肌病、高血压性心脏病、风湿性心脏病及其他。我院慢性心衰住院患者的诊治基本贴合指南推荐。不同射血分数的心力衰竭患者在一般临床资料、合并症及治疗特点存在差异。
Objective To understand the etiology,the comorbidities,the characteristics of diagnosis and treatment of in-hospital patients with chronic heart failure,and to compare the baseline data of heart failure patients with different ejection fractions.Methods A total of 739 patients with chronic heart failure were collected in the Second Clinical Medical College of Shanxi Medical University.The clinical data of heart failure were retrospectively analyzed.Results There were 401(54.3%)males and 338(45.7%)females in this study.The age of patients averaged(66.7±14.5)years(23-99 years).The main causes of chronic heart failure were coronary heart disease(269 cases,36.4%),followed by dilated cardiomyopathy(147 cases,19.9%),hypertensive heart disease(114 cases,15.4%),rheumatic heart disease(83 cases,11.2%)and others(126 cases,17.1%).The proportion of in-hospital patients using diuretics,angiotensin converting enzyme-inhibitors/angiotensin receptor blockers(ACEI/ARB),β-blockers,digitalis,aldosterone receptor antagonists,vasodilators,calcium antagonists and positive inotropic drugs was 86.7%,65.8%,66.8%,37.6%,76.5%,75.0%,28.1%and 49.3%,respectively.In 739 patients with chronic heart failure,there were 248 cases(33.6%)of heart failure with reduced ejection fraction(HFrEF),111 cases(15.0%)of heart failure with mid-range ejection fraction(HFmrEF)and 380 cases(51.4%)of heart failure with preserved ejection fraction(HFpEF).Compared with HFrEF patients,the HFmrEF patients had higher systolic blood pressure and longer hospital stay(P<0.05),and higher usage rate of calcium antagonists(P<0.016 7),and hypertensive heart disease,rheumatic heart disease and combined with pleural effusion were common in the HFmrEF patients.Compared with the HFpEF patients,the HFmrEF patients had a higher proportion of men,smoking,age≤34 years,NYHAⅣ,dilated cardiomyopathy and combined with pleural effusion,and there was higher usage rate of diuretic,ACEI/ARB,β-blockers,and aldosterone receptor antagonists in HFmrEF group(P<0.016 7),and higher diastolic
作者
卫瑾婷
梁斌
杨慧宇
边云飞
杨志明
WEI Jinting;LIANG Bin;YANG Huiyu;BIAN Yunfei;YANG Zhiming(Department of Cardiology,Second Clinical Medical College of Shanxi Medical University,Taiyuan 030001,China)
出处
《山西医科大学学报》
CAS
2019年第6期702-708,共7页
Journal of Shanxi Medical University
关键词
慢性心力衰竭
住院患者
射血分数
回顾性分析
chronic heart failure
inpatients
ejection fraction
retrospective analysis
