不同性别和年龄段老年慢性心力衰竭患者的临床特点

Clinical features of elderly male and female chronic heart failure patients at different ages

目的：回顾调查分析不同性别和年龄段老年治疗慢性心力衰竭住院患者的临床特点，探讨防治对策。方法选择2003年1月～2010年12月住院治疗的老年慢性心力衰竭患者1580例，男性936例，女性644例，60～69岁618例、70～79岁682例和≥80岁280例，比较不同性别患者的临床特征。结果所有患者中，基本病因最多为冠心病702例，占44．4％，男性472例，占50．4％，女性230例，占35．7％，两者比较差异有统计学意义（ P＜0.05）；伴随疾病最多为高血压778例，占49．2％，男性443例，占47．3％，女性335例，占52．0％，两者比较差异有统计学意义（ P＜0．05）。女性各年龄段患者风湿性心脏病发病率显著高于男性（ P＜0．05，P＜0．01）；男性60～69岁和70～79岁冠心病发病率显著高于女性（ P＜0．05，P＜0．01）。与女性比较，男性60～69岁和70～79岁左心衰竭比例明显升高，右心衰竭比例明显降低（ P＜0．01）。男女性病死率都随增龄增高（ P＜0．05，P＜0．01），女性≥80岁增高更显著（P＜0．01）。结论老年慢性心力衰竭住院患者中，高血压、冠心病、肺源性心脏病和肺炎随增龄增多，风湿性心脏病、心肌病随增龄减少，住院期病死率随增龄增高。

Objective To study the countermeasures for prevention and treatment of CHF in hospi-talized elderly male and female patients by retrospectively analyzing their clinical features and da-ta .Methods A total of 1580 elderly male and female CHF patients （935 males and 644 females） adimitted to our hospital were divided into 60 -69 years old group （n=618） ,70 -79 years old group （n=682）and ≥80 years old group （n=280） .Their clinical features were compared .Results The incidence of rheumatic heart disease was signicantly higher in female patients than in male patients （P〈0 .05 ,P〈0 .01） .The incidence of coronary heart disease was signicantly higher in 60-69 and 70-79 years old male patients than in 60-69 and 70-79 years old female patients . The incidence of pneumonia and hypertension increased with increasing age （P〈0 .05 ,P〈0 .01） . The incidence of left heart failure was significantly higher while that of right heart failure was sig-nificantly lower in 60-69 and 70-79 years old male patients than in 60-69 and 70-79 years old female patients （P〈0 .01） .The mortality increased with increasing age in both male and female patients （P〈0.05 ,P〈0 .01） ,especially in ≥80 years old female patients （P〈0 .01） .Conclusion The incidence of hypertension ,coronary and pulmonary heart disease ,pneumonia increases while that of rheumatic heart disease and cardiomyopathy decreases with increasing age in elderly CHF patients .However ,the mortality of hospitalized elderly CHF patients inceases with increas-ing age .