慢性心功能不全患者长期预后的性别差异

Gender Differences for Long-term Prognosis in Patients With Chronic Heart Failure

目的:探讨慢性心功能不全患者长期预后的性别差异。方法:连续入选925例慢性心功能不全住院患者,其中女性460例(49.7%),平均随访3.4年,以全因死亡为终点,通过Cox回归分析慢性心功能不全患者长期预后的性别差异。结果:随访期间,整体全因死亡率27.9%,女性死亡率25.2%,男性死亡率30.5%。多因素Cox回归分析显示,男性患者的长期死亡风险要比女性患者高(HR=1.309,95%CI:1.002~1.708;P=0.048)。亚组分析显示,在年龄≥65岁亚组、左心室射血分数(LVEF)<45%亚组、心功能Ⅲ、Ⅳ级亚组,女性的长期预后要显著好于男性。结论:女性慢性心功能不全患者的长期预后要显著好于男性;而且年龄≥65岁、LVEF<45%、心功能Ⅲ、Ⅳ级的女性患者的预后较好。

Objective： To analyze gender differences for the long-term prognosis in patients with chronic heart failure （CHF）. Methods： A total of 925 consecutive CHF patients admitted in our hospital were enrolled those including 460 （49.7%） female. The mean follow-up time was 3.4 years and the end point event was all-cause mortality. Gender differences for the long-term prognosis in CHF patients were studied by Cox proportional-hazards regression analysis. Results： The overall all-cause mortality was 27.9% during follow-up period, mortality in female was 25.2% and in male was 30.5%. Multivariate Cox regression analysis presented that the long-term death risk in male patients was higher than female （HR=1.309, 95% CI 1.002-1.708, P=0.048）. Subgroup analysis showed that for patients age≥65 years, LVEF〈45%and with NYHA grade III/IV, the long-term prognosis in female was much better than male. Conclusion： Long-term prognosis of CHF in female patients was better than male; female at age≥65 years, LVEF〈45%and NYHA grade III/IV had the better prognosis.