不同病因所致心力衰竭的预后分析  

Prognostic value of etiology in patients with heart failure

作　　者：张恒亮[1] 张培[1] 姚亚丽[2] 

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学第一医院心内科,甘肃兰州730000

出　　处：《心脏杂志》2013年第6期668-672,共5页Chinese Heart Journal

摘　　要：目的:探讨不同病因所致心力衰竭(心衰)对患者预后的影响。方法:回顾性分析2007年1月～2010年12月兰州大学第一医院心内科收治住院的556例心衰患者的临床资料,并进行电话随访,确认患者是否死亡。根据引起心衰的病因不同将研究对象分为冠心病组、高血压病组、扩张型心肌病组(扩心病组)、心脏瓣膜病组和多病因组。Cox比例风险模型评价不同病因组患者的预后差异,并建立Kaplan-Meier生存曲线。结果:共纳入分析患者513人,截止随访结束,死亡231人,占45%;不同病因组患者的年龄、心功能分级、左室射血分数等指标有明显差异(P<0.05);多因素Cox比例风险模型分析显示冠心病组和扩心病组的死亡风险分别为心脏瓣膜病组的2.517倍(P<0.05)和2.480倍(P<0.05)。结论:心衰患者不同病因的预后不同。AIM：To study the prognostic value of etiology in patients with heart failure （HF）. METHODS： Data of inhospital patients with HF in our hospital between January 2007 and December 2010 were investigated and the patients were followedup by telephone. Patients were classified into the following etiology groups, namely, coronary heart disease, hypertension, dilated cardiomyopathy, valvular disease. Multifactors and clinical characteristics in each group were analyzed. Cox proportional hazards analyses were conducted to examine the difference in mortality. RESULTAS： A total of 513 patients with heart failure were enrolled; 231 died by the end of the followup period with a mortality rate of 45%. Significant differences were found in ages, NYHA classes and LVEF among the different groups （P〈0.05）. Multivariate analysis showed that HR in patients with coronary heart disease and dilated cardiomyopathy were, respectively, 2.517 times and 2.480 times than in patients with valvular disease （P〈0.05）. CONCLUSION： Patients with HF have a poor prognosis and high mortality rate. Different etiologies of heart failure demonstrate different clinical characteristics and prognoses.

关 键 词：心力衰竭 病因 预后 

分 类 号：R541.9[医药卫生—心血管疾病]