慢性充血性心力衰竭急性发作370例住院诱因分析  

Characterizatin of the Precipitants of Hospitalization for Chronic Heart Failure Decompensation

作　　者：刘暐[1] 林英[2] 张福春[2] 

机构地区：[1]北京中医药大学第三附属医院心内科,100083 [2]北京大学第三医院心内科

出　　处：《实用心脑肺血管病杂志》2009年第6期461-463,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨慢性充血性心力衰竭失代偿发作住院的诱发因素。方法回顾性分析370例因慢性心力衰竭首次急性发作住院患者的临床资料,明确并排列心力衰竭发作的诱发因素。结果370例慢性心力衰竭失代偿发作住院的患者中,共因心力衰竭急性发作住院584次。359例(97.03%)均有明确的诱发因素导致心力衰竭加重。其中液体潴留239例(64.69%),位居第一;感染161例(43.67%);同时存在感染和水钠潴留96例(25.95%);心肌缺血加重40例(10.81%),其中恶化的心绞痛32例(8.65%),再次心肌梗死8例(2.16%);严重心律失常41例(11.08%);未控制的高血压40例(10.81%);恶化的慢性阻塞性肺病24例(6.49%);严重的电解质紊乱13例(3.51%);劳累激动20例(5.41%);其他诱因13例(3.51%)。结论慢性充血性心力衰竭失代偿发作住院的诱发因素中液体潴留位居第一,控制液体潴留等诱发因素可能降低慢性心力衰竭患者的失代偿发作。Objective To investigate precipitating factors for hospitalization of patients who have chronic heart failure. To ascertain and rank the principal resons for decompensation that leads to hospitalization. Methods We Restropectively studied admissions coded for heart failure between January 1 st, 2000 and December 31st, 2004 at Peking University Third Hospital. For those patients with multiple admissions for decompensations of heart failure, only data from the first admission were included. Totally 370 patients were evaluated for the precipitations of hospitalization for heart failure decompensation. Results Among 370 patients hospitalization for chronic heart failure decompensations, The most important precipitating factors were excessive fluid retention （ n =239 64. 69% ）. The second important precipitating factors were infection （ n = 161 43.67% ）, Other factors precipitatod admission were much less often： uncontrolled hypertension （ n = 40 10. 81% ）, arrhythmia （ n = 41 11.08% ）, unstable angina and/or myocardial infarction （n = 40 10. 81% ）, exacerbation of COPD （n = 24 6. 49% ）, severe electrolyte disorder （n =133.51%）, exertion and agonism （n=205.41%）, otherfactors（n=133.51%）. Conclusion Exeessive fluid retention is the most important precipitating factors for 370 patients hospitalization for chronic heart failure decompensations. Many hospitalization for heart failure might be avoided by case management directed at lessening fluid overload.

关 键 词：慢性心力衰竭 诱发因素 液体潴留 

分 类 号：R541.61[医药卫生—心血管疾病]