射血分数下降的老年与中青年慢性心力衰竭患者临床特点比较

Comparison of clinical characteristics of the elderly and the young and middle aged CHF patients with reduced ejection fraction

目的探究射血分数下降的老年与中青年慢性心力衰竭患者临床特点的差异。方法选择89例老年及52例中青年射血分数下降的慢性心力衰竭患者,对比2组患者一般情况、病因、超声指标、临床症状及药物治疗方面的差异,进一步了解中青年心力衰竭患者的临床特点。结果老年患者的收缩压和低密度脂蛋白明显高于中青年组,而红细胞、血红蛋白和高密度脂蛋白显著比中青年组低,差异均有统计学意义(P<0.05);比较射血分数下降的慢性心力衰竭患者的危险因素,发现老年组患者的高血压、高血脂、缺血性心肌病及合并肾功能不全均显著高于中青年组患者,而年轻患者吸烟、饮酒及扩张性心肌病明显高于老年患者,差异均有统计学意义(P<0.05);中青年患者LVES、LVED及LAD显著高于老年患者,差异均有统计学意义(P<0.05);老年组出现肺部湿啰音、胸腔积液、水肿症状的患者更多,而中青年患者发生心脏肥大更明显,差异均有统计学意义(P<0.05);中青年患者使用强心药及扩血管药更多,老年患者使用利尿药更多,但2组间差异无统计学意义(P>0.05)。结论老年与中青年射血分数下降慢性心力衰竭患者临床特点有差异,可以为中青年心力衰竭的临床诊治提供有效经验依据。

Objective To investigate differences of clinical characteristics of the elderly and the young and middle aged chronic heart failure（ CHF） patients with ejection fraction reduction. Methods Eighty-nine elderly CHF patients with ejection fraction reduction（ elderly patient group） and fifty-two young and middle aged CHF patients with ejection fraction reduction（ younger patient group） were enrolled in the study. The differences of general condition,etiology,ultrasound indexes,clinical symptoms and drug treatment were observed and compared between the two groups to understand further the clinical characteristics of young and middle aged CHF patients with ejection fraction reduction. Results The systolic blood pressure in elderly patient group was（ 125. 68 ± 20. 55） mm Hg,which was significantly higher than that [（ 115. 09 ± 19. 47）mm Hg] in younger patient group,however,the levels of red blood cell,hemoglobin and high density lipoprotein in elderly patient group were significantly lower than those in younger patient group（ P〈 0. 05）. The incidence rates of hypertension,high blood lipids,ischemic cardiomyopathy and ischemic cardiomyopathy combined with renal dysfunction in elderly patient group were significantly higher than those in younger patient group,however the patients with smoking,alcohol consumption and dilated cardiomyopathy in younger patient group were significantly more than those in elderly patient group（ P 〈0. 05）.The levels of LVES,LVED and LAD in younger group were significantly higher than those in elderly group（ P 〈0. 05）. The patients with pulmonary rales,pleural effusion,edema in elderly patient group were significantly more than those in younger patient group,however,the cardiac hypertrophy in younger patients was more obvious（ P 〈0. 05）. The younger patients took more cardiac drugs and vasodilators,however,the elderly patients took more diuretics,but there were no significant differences between two groups（ P〈 0. 05）. Conclusion There were differences in the clinical characteristics between the elderly CHF patients with ejection fraction reduction and the young and middle aged CHF patients with ejection fraction reduction,which can provide effective experiences for clinical diagnosis and treatment of chronic heart failure in young and middle aged patients.