老年心力衰竭住院患者基础病因及并发疾病分析  

Underlying causes and complicating diseases of HF in hospitalized elderly HF patients

作　　者：刘姗姗 边素艳[2] 王逸飞 王彬华 朱剑[2] Liu Shanshan;Bian Suyan;Wang Yifei;Wang Binhua;Zhu Jian(Chinese PLA Medical College Graduate School,Beijing 100853,China)

机构地区：[1]解放军医学院,北京100853 [2]解放军总医院第二医学中心心血管内科国家老年医学临床研究中心慢性心衰精准医学北京市重点实验室 [3]解放军总医院医学创新研究部医学大数据研究中心 [4]解放军总医院医学创新研究部灾害医学研究中心

出　　处：《中华老年心脑血管病杂志》2022年第4期359-362,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81670217);工业和信息化部2020年产业技术基础公共服务平台项目(2020-0103-3-1)。

摘　　要：目的 调查分析老年心力衰竭住院患者心脏基础病因、并发疾病谱构成及性别差异。方法 筛选2008年2月~2019年12月解放军总医院第一医学中心心血管内科老年心力衰竭患者10874例,年龄60~103(72.00±7.60)岁,男性6146例(56.52%),女性4728例(43.48%),参照国际疾病分类标准进行疾病分类,对比不同性别的老年心力衰竭患者的年龄、基础病因和并发疾病的构成情况。结果 男性平均住院年龄明显小于女性[(71.36±7.47)岁vs(72.84±7.68)岁,P<0.05]。男性以60~69岁构成比最大(47.56%),女性以70~79岁构成比最大(41.56%)。老年男性与女性心力衰竭患者的前5位基础病因依次均为缺血性心脏病、原发性高血压、心律失常、瓣膜性心脏病、原发性心肌病。男性缺血性心脏病、原发性心肌病发病率明显高于女性,心律失常、瓣膜性心脏病及原发性高血压发病率明显低于女性(P<0.05,P<0.01)。老年男性与女性心力衰竭患者的前4位并发疾病依次均为血脂异常、慢性肾脏病(CKD)、2型糖尿病、贫血,男性第5位并发疾病为缺血性脑血管病,女性为肥胖。男性血脂异常发病率明显高于女性(90.77%vs 88.60%,P=0.000),CKD(40.40%vs 42.53%,P=0.015)、2型糖尿病(32.04%vs 35.53%,P=0.000)和肥胖(16.29%vs 19.23%,P=0.000)发病率明显低于女性。结论 不同性别的老年心力衰竭住院患者基础病因和并发疾病大致相同,但构成情况存在差异。缺血性心脏病和血脂异常分别为老年心力衰竭住院患者最重要的基础病因和并发疾病。Objective To analyze the difference in underlying causes and complicating diseases of HF and gender in hospitalized elderly heart failure patients.Methods A total of 10874 elderly heart failure patients(6146 males and 4728 females) aged 60-103(72.00±7.60) years admitted to Department of Cardiology, Chinese PLA General Hospital No.1 Medical Center from February 2008 to December 2019 were included in this study.The patients were classified according to the ICD-10.The age, underlying causes and complicating diseases of heart failure in elderly male and female heart failure patients were compared.Results The average age of hospitalized elderly male heart failure patients was significantly younger than that of hospitalized elderly female heart failure patients(71.36±7.47 years vs 72.84±7.68 years, P<0.05).The number of 60-69 years old male heart failure patients and 70-79 years old female heart failure patients was the largest, accounting for 47.56% and 41.56% respectively.The top 5 causes of heart failure in elderly male and female heart failure patients were ischemic heart disease, essential hypertension, arrhythmia, valvular heart disease and primary cardiomyopathy.The incidence of ischemic heart disease and essential hypertension was significantly higher while that of arrhythmia, valvular heart disease and primary cardiomyopathy was significantly lower in elderly female heart failure patients than in elderly male heart failure patients(P<0.05,P<0.01).The top 4 complicating diseases of heart failure in elderly male and female heart failure patients were dyslipidemia, chronic kidney disease, type 2 DM and anemia.The fifth complicating disease of heart failure in elderly male heart failure patients was ischemic cerebrovascular disease while that in elderly female heart failure patients was obesity.The incidence of dyslipidemia was significantly higher while that of chronic kidney disease, type 2 DM and obesity was significantly lower in elderly male heart failure patients than in elderly female heart failure patie

关 键 词：心力衰竭 高血压 心律失常 心性 心肌缺血 血脂异常 

分 类 号：R541.6[医药卫生—心血管疾病]