初发急性心力衰竭住院患者病因及诱因状况的临床研究

Clinical survey of underlying diseases and precipitating factors of first diagnosed acute heart failure in elderly inpatients

目的了解老年初发急性心力衰竭(AHF)患者病因、诱因构成和病因聚集性情况,为临床防治提供线索。方法144例AHF患者按年龄分为老年组和非老年组,对比分析2组间病因、诱因构成和多病因情况。结果老年组前3位基础病因为冠心病(52·1%)、高血压(32·1%)、慢性肾功能衰竭(8·5%),非老年组前3位基础病因为风湿性心脏病(32·6%)、慢性肾功能衰竭(21·7%)、扩张型心肌病(19·6%);在病因聚集性方面,老年组多病因AHF占49·5%,非老年组为9·8%;2组发病诱因均以感染最多见,老年组54·4%,非老年组51·2%;预后方面,老年组住院病死率(33·98%)明显高于非老年组(17·07%)(P<0·05)。结论老年与非老年AHF的病因构成比不同,冠心病、高血压是老年AHF最常见的病因;老年多病因AHF多见;老年AHF患者住院病死率较高;感染是最常见的发病诱因。在老年AHF的预防中应采取有针对性的措施。

Objective To investigate the multiple underlying diseases, precipitating factors of first diagnosed acute heart failure （AHF） in the elderly. Methods 144 patients hospitalized with newly diagnosed AHF were divided into non-senile group and elderly group according to the age of subjects. The underlying diseases, multiplicity of etiology, and inducing factors of AHF were retrospectively analyzed and compared between the two groups. Results The first three underlying diseases were coronary heart disease （CHD, 52. 1% ）, essential hypertension （EH, 32. 1% ）, and chronic renal failure （CRF, 8.5% ） in the elderly group, rheumatic heart disease （RHD, 32. 6% ）, CRF （21.7%）, and dilated cardiomyopathy （DCM, 19.6% ） in non-senile group. The rate of multiple underlying diseases was 49. 5% in the elderly and 9. 8% in non-senile group. Infection was the most common inducing factor of AHF in both groups. Conclusions The most frequent causes of AHF are CHD, EH, and CRF, and the rate of multiple causes of AHF is higher in the elderly patients with AHF.