老年退行性心脏瓣膜疾病心力衰竭的临床分析

Clinical analysis of degenerative valvular heart failure

目的 分析老年退行性心脏瓣膜病（SDHVD）心力衰竭的临床特征及相关因素.方法 回顾分析194例老年心力衰竭住院患者临床资料,根据超声心动图检查有无瓣膜退变分为观察组（94例）及对照组（100例）,对2组的伴随疾病及临床特征进行比较,分析SDHVD的临床特点及相关因素.结果 观察组舒张功能不全、心律失常发生率高于对照组[分别为68.1％（ 64/94）比42.0％ （42/100）,70.2％ （66/94）比39.0％ （38/100）,均P＜0.01],差异有统计学意义.年龄与SDHVD的发病相关（P＝0.021）,高血压、冠心病、颈动脉硬化的相关性无统计学意义.结论 老年患者SDHVD发生心力衰竭时主要表现为舒张功能不全,易出现房性心律失常及传导阻滞（房室传导阻滞、窦房传导阻滞、束支传导阻滞）,年龄是SDHVD发病的独立危险因素.

Objective To analyze the clinical characteristics and the correlative risk factors of senile degen- erative heart valve disease （SDHVD）concomitant with heart failure. Methods The clinical data of 194 elderly SDHVD patients with heart failure was collected. According to the echocardiogram, the patients were divided into 2 groups： control group （ patients without SDHVD, n = 100 ） and SDHVD group （ patients with SDHVD, n = 94 ）. Cardiac function, arrhythmia and concomitant disease were compared between two groups. The related causes of SDHVD were analyzed. Results Diastolic heart failure and arrhythmia were significantly more in the SDHVD group （ P 〈 0.05 ）. Age was related to the invasion of SDHVD. Hypertension, arteriosclerosis, coronary artery disease and diabetes mellitus were not related to SDHVD （P 〉 0.05）. Conclusions SDHVD is prone to diastolic heart failure, atrial arrhythmia and conduction block. Age is an independent risk factor of SDHVD.