新疆地区2058例慢性心力衰竭患者病因构成及药物治疗分析

Etiology and medication of 2058 patients with chronic heart failure in Xinjiang

目的：分析新疆不同民族慢性心力衰竭（CHF）住院患者病因及药物治疗情况。方法：选择2004-01-2015-07来我院首次住院并确诊的汉、维、哈、回族CHF患者共2 058例,对其一般情况、病因构成及药物治疗进行回顾性分析。结果：CHF患者平均年龄为（59.23±13.82）岁,其中汉族平均年龄大于其他民族（均P〈0.05）;心功能分级以Ⅲ~Ⅳ级居多,其中汉族Ⅳ级心功能患者较维族多;汉族平均住院天数较其他民族长（均P〈0.05）。CHF主要病因为冠心病、高血压性心脏病（高心病）和扩张型心肌病（扩心病）,其中维族冠心病较汉族多。住院期间治疗药物以血管紧张素酶抑制剂（ACEI）/血管紧张素受体拮抗剂（ARB）、β受体阻滞剂、利尿剂、硝酸酯类药物及洋地黄为主,其中洋地黄的使用率有逐年下降趋势,ACEI/ARB类药物、β受体阻滞剂使用率呈逐年上升趋势。汉族患者洋地黄的使用率多于维族,维族ACEI/ARB、β受体阻滞剂、螺内酯的使用率多于汉族。结论：近12年来我院住院CHF患者的民族分布中,汉族最多,其次为维族、回族及哈族;4个民族主要病因构成均以冠心病为首,其次为高心病、扩心病和风心病,其中维族CHF患者患冠心病多于汉族。CHF住院患者的药物使用按照指南逐年规范化。

Objective：To analyze the etiology and medication of chronic heart failure（CHF）in different nationalities patients in Xinjiang.Method：From January 2004 to July 2015,2 058 cases with CHF admitted to our hospital for the first time were reviewed.The general situation,the cause of the disease and the drug treatment were analyzed retrospectively.Result：The average age of CHF patients was 59.23±13.82 years old,the average age in Han nationality was greater than that in other nationalities（P〈0.05）.The majority heart function grade wasⅢtoⅣ,the patients with graded 4in Han were more than that in Uighur（P〈0.05）.The average hospitalization time in Han was longer than that in other 3ethnic groups（P〈0.05）.The main causes of CHF were coronary heart disease,hypertensive heart disease and dilated cardiomyopathy,coronary heart disease in Uighur was more than that in Han（P〈0.05）.The main drugs during hospitalization included ACEI/ARB,βblockers,diuretics,nitrates and digitalis,the use of digitalis decreased while ACEI/ARB andβblockers increased year by year.The use of digitalis in Han was more than that in Uigur,while ACEI/ARB,βblockers and spironolactone was higher in Uighur.Conclusion：Over the past 12 years in our hospital,the majority patients with CHF was Han,followed by Uighur,Hui,Kazak;the main cause in four nationalities was coronary heart disease,followed by dilated cardiomyopathy and rheumatic heart disease,and the patients with coronary heart disease in Uighur were more than those in Han.The medication is becoming more and more standardized in accordance with the guidelines in hospitalized patients with CHF.