老年心力衰竭合并心房颤动的临床特点及预后  

Clinical characteristics and prognosis of atrial fibrillation complicated with heart failure in elderly patients

作　　者：尹巧香[1] 王恒[2] 罗慧兰[1] 

机构地区：[1]中国人民解放军空军总医院干部病房心内科,北京市100142 [2]中国人民解放军空军总医院干部病房神经内科,北京市100142

出　　处：《实用老年医学》2013年第3期233-236,共4页Practical Geriatrics

摘　　要：目的 充血性心力衰竭(congestive heartfailure,CHF)常合并持续性心房颤动(atrial fibrillation,AF),并相互恶性影响。本文旨在了解老年CHF住院患者中持续性AF的患病率、病死率及预后。方法 回顾分析老年CHF患者625例,将患者分为2组:AF(+)组(220例)和AF(-)组(405例),比较2组间基本临床资料,在院30d病死率和药物治疗情况。结果 老年CHF住院患者AF患病率为35.2%;与AF(-)组比较,AF(+)组年龄明显增高[(72.6±11.6)岁比(70.1±14.2)岁,P<0.01];AF(+)组最常见病因是瓣膜性心脏病(43.2%比10.8%,P<0.01)和高血压(71.1%比60.4%,P<0.05)。药物治疗方面,AF(+)组的血管紧张素转换酶抑制剂(ACEI)、血管紧张素受体抑制剂(ARB)药物用量均未>40%;AF(+)组在院30d病死率与AF(-)组比较无统计学差异(7.2%比5.1%,P>0.05)。结论 老年CHF住院患者AF患病率高,AF对CHF预后无显著影响。遵循指南用药势在必行。Objective To evaluate the clinical characteristics and prognosis of persistent atrial fibrillation(AF) complicated with congestive heart failure(CHF) in hospitalized elderly patients.Methods A retrospective study was performed in 625 patients(mean age 71.0±13.4 years old,356 males,259 females) with CHF.The patients were divided into two groups by AF(+) and AF(-).The clinical characteristics,prevalence,hospital mortality and pharmacotherapy were examined and compared between two groups.Results Of all the patients,35.2% had AF.Compared with the patients presenting with AF(-),the patients with AF(+) were older(72.6±11.6 vs 70.1±14.2,P<0.01);The most common etiologies were valvular heart disease(43.2% vs 10.8%,P<0.01)and hypertension(71.1% vs 60.4%,P<0.05).Recommended therapy for CHF with angiotensin-converting enzyme inhibitor(ACEI) or angiotensin receptor blocker(ARB) was prescribed less than 40%.There was no significant difference between two groups in the 30-day hospital mortality(7.2% vs 5.1%,P>0.05).Conclusions Among patients hospitalized for CHF,AF shows high incidence,but is not an independent risk for prognosis.Guideline-recommended drug therapy for CHF is essential.

关 键 词：老年人 充血性心力衰竭 持续性心房颤动 预后 

分 类 号：R541.61[医药卫生—心血管疾病]