高龄心衰患者退行性心脏瓣膜病变的影响因素分析

Exploration of the factors influencing the degenerative heart valve disease in elderly patients with heart failure

目的探讨高龄心衰患者合并退行性心脏瓣膜病变(SDHVD)的现状及其影响因素。方法连续纳入2018年10月~2019年3月住院的所有高龄心衰患者,根据心脏超声检查结果筛选合并SDHVD的患者,分析SDHVD与患者年龄、脂蛋白a[Lp(a)]水平及合并疾病等因素的关系。结果共纳入急、慢性心衰的高龄患者162例,平均年龄(88.50±5.11)岁,合并SDHVD者61例(37.65%)。SDHVD表现以单纯主动脉瓣钙化(AVC)为主,占83.61%;病变程度以轻度为主,占54.10%。无SDHVD组与合并SDHVD组年龄、Lp(a)水平及合并冠心病、糖尿病、高血压等疾病比例无统计学差异(P>0.05)。结论高龄心衰患者合并SDHVD比例较高,但以轻度AVC为主要表现形式。未发现年龄,冠心病、糖尿病、高血压等病史以及Lp(a)水平与SDHVD的发生和严重程度存在相关性。

Objective To explore the current situation and influencing factors of senile degenerative heart valve disease (SDHVD) in patients with heart failure. Methods All elderly patients with heart failure hospitalized in our department from October, 2018 to March, 2019 were included to screen out the SDHVD patients by cardiac ultrasound examination. The relations between SDHVD and age, lipoprotein a [Lp (a)] level, and comorbidity were analyzed. Results A total of 162 elderly patients with acute or chronic heart failure were enrolled, with an average age of (88.50±5.11) years, including 61 SDHVD patients (37.65%). The main manifestation of SDHVD was simple aortic valve calcification (AVC), accounting for 83.61%;most cases, or 54.10%, were mild. There was no statistical difference (P > 0.05) between the groups with and without SDHVD in ages, Lp (a) level, coronary heart disease, diabetes, and hypertension. Conclusion SDHVD patients take up a large part in the elderly patients with heart failure, with the mild AVC as the main manifestation. There is still no evidence that the incidence and severity of SDHVD are related to the age, Lp (a) level, coronary heart disease, diabetes, hypertension and other diseases.