高龄老年慢性心力衰竭患者的临床特点分析  

Clinical characteristics of chronic heart failure in very elderly patients

作　　者：于彤彤[1] 王传合[1] 王菁菁[1] 刘双双[1] 韩苏[1] 孙志军[1] 

机构地区：[1]中国医科大学附属盛京医院心内科,辽宁沈阳110004

出　　处：《中国现代医学杂志》2015年第12期94-98,共5页China Journal of Modern Medicine

摘　　要：目的探讨高龄老年慢性心力衰竭患者在临床表现及危险因素方面的特点。方法 1 513例年龄≥65岁的慢性心力衰竭患者按照年龄分为高龄老年组（年龄≥85岁,135例）和老年组（年龄〈85岁,1 378例）。研究高龄老年组的临床特点,并通过二元Logistic回归分析各因素对高龄患者影响的强弱。结果与老年组相比,高龄老年组心功能分级、RAS阻断剂使用率更高;低蛋白血症、贫血更多,糖尿病、缺血性心脏病、瓣膜病、高脂血症更少;HDL更高;血红蛋白、白蛋白、前白蛋白、胆固醇、LDL、TG、SV更低。二元Logistic回归分析发现,低白蛋白（^OR=1.996,95%CI 1.349~2.953）、贫血（^OR=2.211,95%CI 1.503~3.253）对高龄老年组影响更强;糖尿病史（^OR=0.523,95%CI 0.325~0.841）、缺血性心脏病史（^OR=0.638,95%CI 0.440~0.925）、瓣膜病（^OR=0.304,95%CI 0.131~0.709）、高脂血症（^OR=0.643,95%CI 0.447~0.927）则对老年组影响更强。结论低白蛋白、贫血是高龄老年心衰患者的独立影响因素,需要积极控制这些危险因素,才能更好地防治高龄老年心衰。[Objective]To analyze the clinical features and risk factors in very elderly patients presenting with chronic heart failure. [Methods] According to ages, 1,513 elderly heart failure patients were divided into two groups： elderly patient group（age 〈85 years, 1,378 cases） and very elderly patient group（age ≥ 85 years, 135cases）. Baseline clinical features and risk factors were analyzed. Factors affecting the two types of heart failure were analyzed by binary logistic regression analysis.[Results]The very elderly patients had higher NYHA status; higher rates of use of angiotensin converting enzyme inhibitors（ACEI） or angiotensin-receptor blockers（ARB）,hypoproteinemia, anemia and HDL; lower rates of diabetes, ischemic heart disease, valvular heart disease and hyperlipidemia; lower SV, hemoglobin, albumin, prealbumin, TC, LDL and TG levels than the elderly ones. Binary logistic regression analysis revealed that hypoproteinemia（ ^OR=1.996, 95% CI 1.349~2.953） and anemia（ ^OR=2.211,95% CI 1.503 ~3.253） were significantly related with the very elderly patients; while diabetes（ ^OR =0.523, 95% CI0.325~0.841）, ischemic heart disease（ ^OR=0.638, 95% CI 0.440~0.925）, valvular heart disease（ ^OR=0.304, 95% CI0.131 ~0.709） and hyperlipidemia（ ^OR =0.643, 95% CI 0.447 ~0.927） were significantly related with the elderly patients. [Conclusions]Hypoproteinemia and anemia are independently correlated with very elderly chronic heart failure patients. More attentions should be paid to these risk factors for very elderly patients to prevent and treat heart failure.

关 键 词：高龄老年 心力衰竭 临床特点 危险因素 

分 类 号：R541.61[医药卫生—心血管疾病]