老年慢性心力衰竭患者的临床特点分析  

Analysis of clinical characteristics and risk factors for chronic heart failure in the elderly

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

机构地区：[1]沈阳中国医科大学附属盛京医院心内科,110004

出　　处：《中华老年医学杂志》2015年第9期947-950,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨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。方法入选2407例慢性心力衰竭患者，其中年龄≥65岁组1513例（62．9％），回顾性分析其心力衰竭危险因素、临床表现及生化物理检查的特点，Logistic回归分析各因素对不同年龄患者的影响。结果与〈65岁组比较，≥65岁组心功能分级高；糖尿病、缺血性心脏病、高血压、贫血、肾功能不全、高尿酸血症多；收缩压高，但舒张压低；男性、吸烟、扩张心肌病、瓣膜病、高脂血症少。≥65岁组血肌酐、高密度脂蛋白胆固醇、血钾高，血红蛋白、白蛋白、前白蛋白、胆固醇、低密度脂蛋白胆固醇、三酰甘油低。≥65岁组的左心室射血分数高。与〈65岁组比较，≥65岁组肾素-血管紧张素阻断剂和他汀使用率更高，但β受体阻断剂使用率低。Logistic分析结果显示，性别（OR=1．89，95％CI：1．566～2．285）、缺血性心脏病史（OR=1．81，95％CI：1．457～2．243）、高血压（OR—1．87，95％CI：1．462～2．389）、贫血（OR=2．66，95％CI：2．197～3．211）、高尿酸血症（OR=1.41，95％CI：1．186～1．678）对≥65岁组影响更强；扩张心肌病（OR=0．49，95％CI：0．351～0．689）、高脂血症（OR=0．53，95％CI：0．433～0．641）、吸烟（OR=0．79，950ACI：0．652～O．966）则对〈65岁组影响更强。结论性别、缺血性心脏病史、高血压、贫血、高尿酸血症是老年心力衰竭患者的独立影响因素。Objective To investigate the clinical features and risk factors for chronic heart failure in elderly patients. Methods The 2,407 chronic heart failure patients were enrolled, including 1,513 elderly patients （62.9 %） （aged≥ 65 years）. Risk factors for chronic heart failure, clinical features, biochemical and physical examination were retrospectively analyzed. The effects of different factors on patients with different age were analyzed by Logistic regression analysis. Results Compared with the young and middle-aged patients, the higher prevalences of New York Heart Association functional classification （NAFC）, diabetes, ischemic heart disease,hypertension, anemia, renal insufficiency and hyperuricemia were found, but the percentages of males, smoker, patients with dilated cardiomyopathy, valvular heart disease and hyperlipidemia were reduced in elderly patients. The levels of blood creatinine, high density lipoprotein （HDL）, serum potassium, hemoglobin, albumin, pre-albumin, total cholesterol （TC）, lower density lipoprotein （LDL）, triglyceride （TG） and diastolic blood pressure were lower, but left ventricular ejection fraction （LVEF） and systolic blood pressure were higher, in the elderly patients than in young and middle-aged patients. Elderly patients had higher usage rates of stain and angiotensin converting enzyme inhibitors （ACEI） or angiotensin receptor blocker （ARB）, but lower usage rate of β - blocker as compared with young and middle-aged patients. In elderly patients, logistic regression analysis revealed that gender （OR： 1.89, 95%CI： 1. 566-2. 285）, a history of ischemic heart disease （OR= 1.81,95% CI： 1. 457-2. 243）, hypertension （OR= 1.87, 95% CI： 1. 462-2. 389）, anemia （OR= 2.66, 95% CI： 2. 197-3. 211）, hyperuricemia （OR= 1.41, 95% CI： 1. 186-1. 678） were significantly related with chronic heart failure, whilein young and middle-aged patients, dilated cardiomyopathy （ OR = 0.49,95 % CI 0.351-0. 689）, hyperlipidemia （OR

关 键 词：心室功能障碍 危险因素 

分 类 号：R541.6[医药卫生—心血管疾病]