多中心、前瞻性中国心力衰竭注册登记研究——病因、临床特点和治疗情况初步分析

China Heart Failure Registry Study——A Multicenter,Prospective Investigation for Preliminary Analysis on Etiology,Clinical Features and Treatment in Heart Failure Patients

目的：了解中国住院心力衰竭（心衰）患者病因、临床特点和治疗情况。方法：根据地域及经济分布前瞻性入选因心衰住院的患者。通过电子病例报告表收集患者的人口学信息、心衰病因、临床特点和治疗情况。结果：自2012-01至2014-12共有国内88家医院提供8 516例心衰患者数据进行分析,患者平均年龄66岁,54.5%为男性,大部分患者为美国纽约心脏协会心功能Ⅲ~Ⅳ级,占84.7%（6 777/7 997）。心衰患者中冠心病占49.4%（4207/8 516）、高血压占54.6%（4 649/8 516）,慢性肾脏病占29.7%（2 109/7 102）,左心室射血分数〈40%的患者占37.5%（2 478/6 608）。感染（45.9%,3 909/8 516）、劳累或应激反应（26.0%,2 214/8 516）及心肌缺血（23.1%,1 967/8 516）是引起心衰加重的主要诱因。住院期间静脉利尿剂的应用率为72.4%（6 165/8 516）,出院后口服袢利尿剂应用率为67.2%（5 722/8 516）,血管紧张素转换酶抑制剂应用率为30.1%（2 563/8 516）,血管紧张素Ⅱ受体拮抗剂应用率为24.6%（2 095/8 516）。患者住院时间的中位数为11天,住院死亡率为5.3%（451/8516）。结论：中国心衰注册登记研究比较全面地介绍了当前中国住院心衰患者的临床特征。目前中国心衰患者的药物治疗与指南指导的药物治疗之间仍存在差距,需进一步加强对患者及临床医师的教育。

Objective：China Heart Failure Registry Study（China-HF） is aimed to understand the etiology,clinical features and treatment of in-hospital heart failure（HF） patients in China.Methods：Based on geographic region and economic condition,we prospectively recruited the in-hospital patients with primarily diagnosed HF,and the demographic information,etiology,clinical features and treatment condition were collected by electronic case report form in all patients.Results：A total of 8516 HF patients from 88 participating hospitals between 2012-01 and 2014-12 were analyzed.The average age of patients was at 66 years with 54.5% male.There were 6777/7997（84.7%） patients with NYHA functional classification at III-IV,4207/8516（49.4%） with coronary artery disease（CAD）,4649（54.6%） with hypertension,2109/7102（29.7%） with chronic kidney disease and 2478/6608（37.5%） with left ventricular ejection fraction（LVEF） 〈 40%.The patients with infection 3909/8516（45.9%） and exertion or stress 2214（26.0%） and myocardial ischemia 1967（23.1%） were the major cause of HF worsening.There were 6165/8516（72.4%） patients treated by intravenous diuretics during hospitalization,and after discharge,5722（67.2%） patients received oral loop diuretics,2563（30.1%） received angiotensin converting enzyme inhibitor,2095（24.6%） received angiotensin II receptor antagonist.The median length of in-hospital stay was 11 days and the in-hospital mortality was 5.3%（451/8516）.Conclusion：China-HF provides a comprehensive insight of clinical features for the in-hospital HF patients in China.There is still a gap for medications between our current condition and the guideline,it is important to educate both patients and physicians in clinical practice.