急性老年晕厥患者临床特征和预后危险因素分析  

Clinical characteristics and risk factors of short-and mid-term quality of life and prognosis in elderly pa-tients with acute syncope

作　　者：杜娟 张娜娜 Du Juan;Zhang Nana(Department of Neurology,Dengzhou People′s Hospital,Henan 474150,China;Department of Cardiology,the People′s Hospital of Henan,Zhengzhou 471000,China)

机构地区：[1]河南省邓州市人民医院神经内科,474150 [2]河南省人民医院心内科,郑州450000

出　　处：《中国药物与临床》2022年第3期212-215,共4页Chinese Remedies & Clinics

摘　　要：目的探讨老年急性晕厥患者临床特征和预后危险因素。方法选取邓州市人民医院2020年2月至2021年2月收治的130例老年急性晕厥患者作为研究对象。检测患者血脂、血糖、血压等指标,收集患者病史、个人基本信息、生活习惯等资料,对患者展开为期4个月的院后随访并统计患者终点事件(心源性休克、死亡、二次入院、不良心血管事件、血运重建、脑梗死、心肌梗死、心律失常等)发生率;分析老年急性晕厥患者临床特征、近中期生存质量及终点事件因素。结果突发性头晕(63.9%)、心悸(54.6%)、四肢无力(50%)是老年急性晕厥患者的主要临床症状;患者院后1、2、3、4个月的无终点事件生存率分别为100%(130/130)、88.5%(115/130)、75.9%(98/130)、69.2%(90/130);多因素分析显示,吸烟[OR(95%CI):1.521(1.275,2.470)]、糖尿病[OR(95%CI):2.055(1.376,2.471)]、肥胖[OR(95%CI):2.896(1.388,2.473)]、高血脂[OR(95%CI):3.254(1.397,2.488)]、运动不足[OR(95%CI):3.835(2.990,4.560)]、腹型肥胖OR(95%CI):4.180(2.970,5.129)]、短暂意识丧失病史[OR(95%CI):4.841(2.669,6.241)]是老年急性晕厥患者终点事件发生的独立危险因素(P<0.05)。结论老年急性晕厥患者主要表现为突发性头晕、心悸、恶心、乏力等症状,近中期不良事件的发生率较高,全身性慢性病、不良生活习惯、TLOC病史等是老年急性晕厥患者院后不良事件发生的独立危险因素。Objective To investigate the clinical characteristics and prognostic risk factors of elderly pa-tients with acute syncope.Methods A retrospective analysis was performed for 130 elderly patients with acute syncope admitted to Dengzhou People′s Hospital between February 2020 and February 2021.The patients were examined for blood lipids,blood sugar,and blood pressure,and recorded for information on their medical history,demography,lifestyle,occurrence of end-point events(cardiogenic shock,death,second hospital admission,ad-verse cardiovascular events,revascularization,cerebral infarction,myocardial infarction,and arrhythmia)during the four-month follow-up after discharge.The clinical characteristics,short-and mid-term quality of life and risk factors of end-point events in elderly patients with acute syncope were analyzed.Results Sudden dizziness(63.9%),palpitations(54.6%),and limb weakness(50.0%)were the major clinical symptoms in these elderly pa-tients with acute syncope.The event-free survival ratesin the patients at 1,2,3,and 4 months after hospitalization were 100%(130/130),88.5%(115/130),75.4%(98/130),and 69.2%(90/130).Multivariate analysis showed that smoking OR(95%CI):1.521(1.275,2.470);diabetes OR(95%CI):2.055(1.376,2.471);obesity OR(95%CI):2.896(1.388,2.473);Hyperlipidemia OR(95%CI):3.254(1.397,2.488),physical inactivity OR(95%CI):3.835(2.990,4.560);abdominal obesity OR(95%CI):4.180(2.970,5.129),history of transient loss of consciousness(TLOC)OR(95%CI):4.841(2.669,6.241)were independent risk factors for the end-point events in elderly patients with acute syncope(P<0.05).Conclusion Elderly patients with acute syncope mainly present with symptoms such as sud-den dizziness,palpitations,nausea,and fatigue and are at higher risk of short-and mid-term adverse events.Chronic systemic diseases,unhealthy lifestyle habits and a TLOC historyare independent risk factors for adverse events in elderly patients with acute syncope after hospital discharge.

关 键 词：晕厥 老年人 体征和症状 预后 

分 类 号：R741[医药卫生—神经病学与精神病学]