影响老年性慢性心力衰竭反复发作因素分析

Factors affecting recurrent episodes of chronic heart failure in the elderly

目的探究老年性慢性心力衰竭反复发作的危险因素。方法回顾性分析2017年8月至2019年7月收治的278例老年性慢性心力衰竭患者的临床资料,分析患者病情反复发作的危险因素。结果在1年内,278例老年慢性心力衰竭患者中,有71例患者病情反复发作,复发率为25.54%。复发患者年龄80岁以上,美国纽约心脏病学会(NYHA)心功能分级Ⅳ级、服药依从性差、日常摄水量>700 mL、吸烟饮酒、抑郁焦虑、原有心脏病情加重且多合并症所占比例显著高于未复发患者(P<0.05)。每个月复诊所占比例显著低于未复发患者(P<0.05)。经多因素Logistic回归分析显示,年龄80岁以上,NYHA分级Ⅳ级、服药依从性差、日常摄水量>700 mL、吸烟饮酒、抑郁焦虑、原有心脏病情加重且多合并症是老年性慢性心力衰竭复发的独立危险因素,每个月复诊是其保护因素。结论针对老年性慢性心力衰竭反复发作的独立危险因素,需给予针对性饮食、用药、心理疏导等方面干预管理,以减少病情复发。

【Objective】To explore the risk factors of recurrent chronic heart failure in the elderly.【Methods】The clinical data of 278 elderly patients with chronic heart failure admitted between August 2017 and July 2019 were retrospectively analyzed,and single-factor and multi-factor analysis were conducted to analyze the risk factors of patients'repeated attacks.【Results】In one year,71 of the 278 elderly patients with chronic heart failure had recurrent attacks,with a recurrence rate of 25.54%.The proportion of relapsed patients over 80 years old,with NYHA grade IV,poor medication compliance,daily water intake>700 mL,smoking and drinking,depression and anxiety,exacerbation of heart disease and multiple comorbidities was significantly higher than that of patients without relapse(P<0.05).The percentage of monthly recurrence clinics was significantly lower than that of non-recurring patients(P<0.05).Multivariate logistic regression analysis showed that over 80 years old,NYHA grade IV,poor medication compliance,daily water intake>700 mL,smoking and drinking,depression and anxiety,aggravation of the original heart disease,and multiple complications were independent risk factors of senile chronic heart failure recurrence,and monthly follow-up visits were protective factors.【Conclusion】Regarding the independent risk factors of recurrent chronic heart failure in the elderly,intervention and management of targeted diet,medication,and psychological counseling are required to reduce the recurrence of the disease.