老年舒张性心力衰竭的临床特点分析

The clinical features of diastolic heart failure incidence in elderly patients

目的分析老年舒张性心力衰竭(DHF)发病的临床特点。方法对2012年3月至2013年12月我科收治的57例临床诊断为舒张性心力衰竭患者临床资料进行回顾性分析,通过生化检查、B型脑钠肽(BNP)水平测定、超声心动图、心电图、全胸片等检查,对DHF患者的BNP水平、心超特点以及基础疾病进行分析。结果 DHF患者的BNP水平明显增高,平均值为594.7pg/mL(正常值<100 pg/mL),心脏超声特点为左心房明显增大占84.2%,平均值为44.6 mm,肺动脉压升高占71.9%,平均值48.5mmHg,室间隔肥厚的患者占19.3%,平均值10.4 mm,左室后壁增厚占8.7%,平均值9.7 mm,LVEF大致正常;心电图检查房颤占56.1%,所患基础疾病:心房颤动、高血压病、冠心病、糖尿病分别占56.1%、66.7%、47.3%和21.1%。结论心房颤动、高血压病、冠心病、糖尿病等疾病可能是发生DHF的主要病因,心超检查和BNP水平监测、心电图检查是诊断DHF的重要手段。

Objective To analyse the clinical features of the incidence of elderly diastolic heart failure.Methods There were 57 cases of patients with a clinical diagnosis of diastolic heart failure,and the data were analyzed retrospectively in the Department of Vasculocar-diology of the Hospital from March 2012 to December 2013.All patients were conducted biochemical tests,BNP levels,echocardiography, chest X-ray and other tests.The levels of BNP,echocardiographic characteristics for patients with DHF and underlying diseases were ana-lyzed.Results The levels of BNP were significantly higher in patients with DHF,with the average of 594.7 pg/mL （normal〈100 pg/mL）. The echocardiographic features suggestive of left atrium significantly increased 84.2% with an average of 44.6 mm in the group of patients with DHF,pulmonary hypertension （71.9%）,with the average of 48.5 mmHg,septal hypertrophy in 19.3%,with the mean of 10.4 mm,left ventricular posterior wall thickening （8.7%）,with the average of 9.7 mm,and the EF was normal.ECG atrial fibrillation prompted 56.1%, the patients with DHF suffering from underlying diseases such as atrial fibrillation,hypertension,coronary atherosclerotic heart disease,diabe-tes,which accounted for respectively 56.1%,66.7%,47.3%and 21.1%.Conclusion The disease of atrial fibrillation,hypertension,coro-nary atherosclerotic heart disease,diabetes may be reasons of DHF.Echocardiography,BNP levels and ECG will be important means for the diagnosis of DHF.