老年高血压患者发生射血分数保留心衰的危险因素分析  

Analysis on the risk factor of ejection fraction preserve heart failure in elderly hypertensive patients

作　　者：宋婷婷[1] 贾红丹[1] 国强华[1] 崔蕊[1] 刘丽[1] SONG Ting-ting;JIA Hong-dan;GUO Qiang-hua;CUI Rui;LIU Li(Department of Cardiology, the First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei, Chin)

机构地区：[1]秦皇岛市第一医院心血管内科,河北秦皇岛066000

出　　处：《川北医学院学报》2018年第2期158-161,共4页Journal of North Sichuan Medical College

基　　金：河北省秦皇岛市科技局科学技术研究与发展计划编号(201602A124)

摘　　要：目的:探讨伴随老年高血压患者发生射血分数保留心衰(ejection fraction preserve heart failure,EFp HF)的危险因素,以期为该类患者的治疗及预防提供参考。方法:分析96例HFp EF合并高血压患者的临床资料,并列为观察组;对照组101例为高血压合并射血分数正常非心衰患者。对可能影响HFp EP患者疾病发生及发展进程的因素进行单因素分析,对具有差异的指标进一步采用多因素Logistic回归分析,得出具有影响该病的独立危险因素。结果:两组患者在性别比例、年龄、体质指数(BMI)、吸烟比较上,差异均有统计学意义(P<0.05);两组患者在房颤、糖尿病、冠心病、肾功能不全、贫血、呼吸睡眠暂停病史水平发生率比较上,差异均有统计学意义(P<0.05);HFp EF合并高血压患者不同心功能分级LEVF、LVDd、LVST、E/A、LAV及血清NT-pro BNP水平比较,差异均有统计学意义(P<0.05)。HFp EF患者随着心功能升高LVDd、LVST、LAV及血清NT-pro BNP水平升高,LEVF、E/A水平呈下降趋势;高龄、超重、吸烟、糖尿病、冠心病是HFp EF合并高血压患者发病的危险因素。结论:高龄、超重、吸烟、糖尿病、冠心病是HFp EF合并高血压患者发病的危险因素,心功能分级越严重,心肌重构、心房功能改变就越明显。Objective： To investigate the risk factor of ejection fraction preserve heart failure in elderly hypertensive patients,in order to provide reference for the treatment and prevention of this kind of patients in clinical practice. Methods： The clinical data of 96 patients with HFp EF combined with hypertension were analyzed and included in the observation group. The 101 patients in the control group were hypertensive patients with normal ejection fraction and non-heart failure. The univariate analysis was performed on the factors that may influence the occurrence and development of the disease in HFp EP patients. Multivariate logistic regression analysis was used to analyze the indicators with differences,and independent risk factors affecting the disease were obtained. Results： There were significant differences in gender,age,body mass index（ BMI） and smoking comparison between the two groups（ P〈0. 05）. There ware significant differences in the incidence of atrial fibrillation,diabetes,coronary heart disease,renal insufficiency,anemia,and respiratory apnea history between the two groups（ P〈0. 05）. The levels of LEVF,LVDd,LVST,E/A,LAV and serum NT-pro BNP in patients with HFp EF and hypertension were significantly different（ P〈0. 05）. In patients with HFp EF,the levels of LVDd,LVST,LAV and serum NT-pro BNP increased with the increase of cardiac function,and the levels of LEVF and E/A decreased. Older age,overweight,smoking,diabetes,and coronary heart disease were risk factors for the onset of HFp EF in patients with hypertension. Conclusion： Older age,overweight,smoking,diabetes mellitus,and coronary heart disease are risk factors for the onset of HFp EF in patients with hypertension. The more serious the cardiac function class is,the more obvious the changes of myocardial remodeling and atrial function are.

关 键 词：射血分数保留心衰 高血压 危险因素 老年 

分 类 号：R544.1[医药卫生—心血管疾病]