心力衰竭住院患者的病因谱及危险因素构成分析

Analysis the etiology and risk factors of the hospitalized patients with heart failure

目的分析急、慢性心力衰竭(HF)患者的病因特点和危险因素。方法收集2010年1月1日—2011年3月31日心内科连续收治的急、慢性HF患者323例,分析其年龄特点、伴随疾病和导致HF的病因谱。结果 323例患者中男139例(43.0%),平均年龄(76±11)岁,女184例(57.0%),平均年龄(79±8)岁,女性患者年龄大于男性患者(P<0.05)。引起HF的最直接原因依次为冠心病(42.1%)、高血压病(19.2%)、特发性心律失常(5.0%)、心脏瓣膜病(5.0%)、扩张型心肌病(4.3%)、肥厚型心肌病(0.9%)和心肌炎(0.3%),尚有23.2%的HF患者不能确定病因。与HF发生发展相关的危险因素依次为高血压病(79.0%)、慢性肾脏疾病(CKD)Ⅲ期(36.5%)、贫血(36.2%)、心房颤动(33.1%)、左心室肥厚(31.0%)、2型糖尿病(30.7%)、中重度心脏瓣膜功能不全(28.5%)、永久性心脏起搏(7.1%)。结论 HF住院患者的年龄较大,最主要的致HF原因是冠心病,近80%的患者患有高血压病,故有效控制高血压、降低冠心病尤其是心肌梗死发病率,应该是降低HF发生的关键环节。

Objective To analyze the etiology and risk factors of the hospitalized patients with acute/chronic heart failure(HF).Methods 323 continuous patients with acute or chronic HF admitted to our hospital from January 1,2010 to March 31,2011 were enrolled.Patients' age,associated comorbidities and the reasons leading to HF were analyzed.Results The male patients(n=139,43.0%)with average age of(76±11)years old were younger than the female patients(n= 184,57.0%)with average age of(79±8)years old(P<0.05).Coronary artery disease(CAD)ranked the first(42.1%) in the etiology which leading to HF,the second reason was hypertension(HBP,19.2%),followed by primary arrhythmias (5.0%),valvular heart disease(5.0%),dilated cardiomyopathy(DCM,4.3%),hypertrophic cardiomyopathy(HCM, 0.9%)and viral myocarditis(0.3%),undetermined reason in 23.2%.The most important HF related risk factor is HBP (79.0%),followed by CKDⅢ(36.5%),anemia(36.2%),AF(33.1%),LVH(31.0%),type 2 diabetes(30.7%), valvular dysfunction(28.5%),permanent right ventricular pacing(7.1%).Conclusion The hospitalized patients with HF were aging people combined with CAD,nearly 80%of patients suffered from HBP.Therefore,it was important to control blood pressure and decrease the incidence of myocardial infarction.