中国西南地区心力衰竭发病情况回顾性研究分析  

Retrospective Study of the Incidence of Heart Failure in Southwest China

作　　者：马里兰 杨瑛 陈章荣 吴新华 陈安琪 刘宏 刘权仪 杨伟 张健[2] MA Lilan;YANG Ying;CHENZhangrong;WU Xinhua;CHEN Anqi;LIU Hong;LIU Quanyi;YANG Wei;ZHANG Jian(Department of Cardiovascular,the First Affiliated Hospital of Dali University,Dali 671000,China;Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100037,China)

机构地区：[1]大理大学第一附属医院心内科,云南省大理市671000 [2]中国医学科学院阜外心血管病医院,北京市100037

出　　处：《中国全科医学》2019年第14期1678-1683,共6页Chinese General Practice

基　　金："十二五"国家科技支撑计划重大项目(2011BA111B02);国家自然科学基金资助项目(81560073)

摘　　要：背景随着我国人口老龄化程度加深,心力衰竭发病率逐年上升,5年病死率达半数以上,是心血管领域尚未攻克的"堡垒",防治心力衰竭已成为我国卫生事业重要组成部分。了解心力衰竭临床特征对其防治有深远意义。目的了解中国西南地区心力衰竭患者临床特征,为本地区心力衰竭的防治提供科学依据。方法采用回顾性分析方法,选取2009年1月—2016年10月大理大学第一附属医院、云南省保山市人民医院、云南省昭通市第一人民医院、云南省德宏州人民医院、云南省曲靖市第一人民医院、贵州省人民医院、贵州省黔南州人民医院、贵州省兴义市人民医院、贵州省黔东南州人民医院、贵州省黔西南州人民医院、四川省广安市人民医院、重庆医科大学附属第一医院因心力衰竭入院的3 674例患者,剔除资料不全、缺失或错误的病例,共3 516例。分析患者性别、年龄、心功能分级、病因分布、左心室射血分数、左心室舒张末期内径、脑钠肽(BNP)、电解质、甲状腺素水平、贫血、总胆红素、尿酸水平等临床特征。结果 3 516例患者中心功能Ⅱ级893例(25.40%),Ⅲ级1 465例(41.67%),Ⅳ级1 158例(32.93%);病因中以冠心病1 142例(32.45%),高血压684例(19.45%),心肌病457例(13.00%)为主;3 516例患者中777例无心脏彩超结果,2 739例患者中射血分数降低的心力衰竭(HFrEF)733例(26.76%),射血分数中间值的心力衰竭(HFmrEF)335例(12.23%),射血分数保留的心力衰竭(HFpEF)1 671例(61.01%)。心功能越差,HFrEF、HFmrEF发病率越高,HFpEF发病率、左心室射血分数越低,左心室舒张末期内径越大,BNP水平越高(P<0.05)。患者低钾血症发生率为16.21%(481/2 967),高钾血症发生率为1.38%(41/2 967)。心功能越差,低钾血症发病率越高(P<0.05)。不同心功能分级患者血钠水平比较,差异有统计学意义(P<0.05);其中心功能Ⅳ级患者血钠水平低于心功能Ⅱ级�Background In China,with the intensification of population aging,the incidence of heart failure(HF)is on the rise year by year,with a 5-year mortality rate of over 50%.HF has become a“fortress”in the field of cardiovascular medicine that needs to be conquered.The prevention and treatment of HF are an important health task in our country,so understanding the clinical manifestations of HF is of great significance.Objective To explore the clinical characteristics of HF patients in southwest China,offering a scientific basis for the prevention and treatment of HF in this region.Methods This study was conducted following a retrospective design.Participants were 3 674 HF inpatients selected from 12 hospitals(the First Affiliated Hospital of Dali University,Baoshan People's Hospital,the First People's Hospital of Zhaotong,Dehong People's Hospital,Qujing First People's Hospital,Guizhou Provincial People's Hospital,Qiannan People's Hospital,Xingyi People's Hospital,Qiandongnan People's Hospital,Qianxinan People's Hospital,the People's Hospital of Guang'an City,the First Affiliated Hospital of Chongqing Medical University)in Southwest China from January 2009 to October 2016.After excluding those with incomplete,missing or wrong data,3 516 cases were finally included.Sex,age,NYHA class,etiology,levels of left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),brain natriuretic peptide(BNP),electrolytes,thyroxine,anemia,total bilirubin,uric acid and other clinical characteristics were compared between them.Results Among the participants,the percentages of NYHA classⅡ,Ⅲ,andⅣHF were 25.40%(893/3 516),41.67%(1 465/3 516)and 32.93%(1 158/3 516),respectively.The percentages of HF caused by coronary heart disease,hypertension and cardiomyopathy were 32.45%(1 142/3 516),19.45%(684/3 516)and 13.00%(457/3 516),respectively.Except for 777 cases,2 739 had echocardiography results.The percentages of reduced ejection fraction(HFrEF),mid-range ejection fraction(HFmrEF)and preserved ejection fracti

关 键 词：心力衰竭 临床特点 病因 心功能分级 

分 类 号：R541.6[医药卫生—心血管疾病]