老年慢性收缩性心力衰竭患者远期预后的影响因素  

Factors of the long-term prognosis in elderly patients with chronic systolic heart failure

作　　者：石亚楠[1] 徐予[2] 朱中玉[2] 高传玉[2] 赵先锋[1] 崔常贺[3] 李蓓[1] 李丹[1] 陈松虎[3] 国杨[3] 

机构地区：[1]新乡医学院,河南新乡453003 [2]河南省人民医院心内科 [3]郑州大学医学院

出　　处：《临床心血管病杂志》2013年第9期683-686,共4页Journal of Clinical Cardiology

摘　　要：目的：分析老年慢性收缩性心力衰竭患者远期生存情况及影响因素。方法：本研究为单中心回顾性研究。316例经超声心动图证实左室射血分数（LVEF）≤45%的缺血性心肌病和扩张型心肌病的老年患者,分为LVEF≤35%（152例）和LVEF 36%~45%（164例）两组,中位随访时间31（8~61）个月。研究终点为全因死亡。结果：共有112例死亡。LVEF≤35%的患者全因死亡率为49%,而LVEF 36%~45%的患者全因死亡率为23%（P〈0.01）。多因素COX回归分析显示,年龄、BMI、血尿酸及LVEF 4个因素对老年慢性收缩性心力衰竭患者的全因死亡率有影响（HR分别为1.050、0.573、1.002及0.968,95%CI分别为1.019~1.083、0.435~0.756、1.001~1.003及0.944~0.992,各指标P〈0.05）。结论：老年慢性收缩性心力衰竭的预后很差,特别是LVEF≤35%的患者。老年、低BMI、高尿酸血症、低LVEF是影响老年心力衰竭患者生存的独立危险因素。Objective：To analyze the long-term situation and the impact of factors in elderly patients with chro- nic systolic heart failure. Method：This study was a single center retrospective study. The 316 cases with left ven- tricular ejection fraction （LVEF）≤45% in isehemie cardiomyopathy or dilated cardiomyopathy were divided into two groups： LVEF≤35% （n= 152） and LVEF 36%--45% （n= 164） group. Patients were followed up for a median of 31 months （8--61 months）. The study endpoint was all-cause death. Result：A total of 112 cases was dead. All-cause mortality was 49% in LVEF≤35% group, and23% in LVEF36%--45% group （P（0.01）. A Cox regression analysis showed that the predictors of all-cause mortality were age, BMI, uric acid and LVEF in elderly patients with chronic systolic heart failure （HR 1. 083, 0. 435--0. 756, 1. 001--1. 003 and 0. 944--0 were 1. 050, 0. 573, 1. 002 and 0. 968, 95%CI were 1. 019- 992, P〈0.05）. Conclusion： Elderly patients with chronic sys tolic heart failure have a poor prognosis, especially for patients with LVEF ≤35%. Age, low BMI, high uric acid and low I.VEF are independent risk factors impacting the survival in elderly patients with heart failure.

关 键 词：心力衰竭 老年 预后 体重 

分 类 号：R541.6[医药卫生—心血管疾病]