慢性心力衰竭患者临床特征及心血管不良事件的危险因素分析  

Clinical features and risk factors of cardiovascular adverse events in patients with chronic heart failure

作　　者：贾婉茹 项欣 王璐 尚文涛 薄晓红[1] Jia Wanru;Xiang Xin;Wang Lu;Shang Wentao;Bo Xiaohong(People's Hospital of Taihe County(Taihe Hospital affiliated to Wannan Medical College),Taihe 236600,China;不详)

机构地区：[1]太和县人民医院(皖南医学院附属太和医院),太和236600

出　　处：《中国循证心血管医学杂志》2024年第3期304-306,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：安徽省卫生健康科研项目(AHWJ2022c008)。

摘　　要：目的探讨慢性心力衰竭(心衰)患者的临床特征及心血管不良事件危险因素。方法选择2021年4月至2022年12月于太和县人民医院收治的135例慢性心衰患者进行研究,根据随访情况分为发生心血管不良事件组(n=41)和未发生心血管不良事件组(n=94)。收集患者临床资料,分析慢性心衰患者的临床特点,采用多因素Logistic回归模型分析慢性心衰发生心血管不良事件的危险因素。结果患者男女比率为61:74,NYHA心功能分级Ⅱ级32例,Ⅲ级71例,Ⅳ级32例。其中引起慢性心衰的病因主要为冠心病(45.93%,62/135)、高血压性心脏病(33.33%,45/135)、扩张型心肌病(12.59%,17/135),风湿性心脏病(2.22%,3/135)、肺源性心脏病(1.48%,2/135)、先天性心脏病(1.48%,2/135)及其他(2.96%,4/135)。随访发现,患者共发生心血管不良事件41例;单因素分析结果显示,两组患者在性别、体质指数(BMI)、高血压、心率、饮酒、心房颤动(房颤)、收缩压、舒张压、空腹血糖、糖化血红蛋白及合并疾病方面比较,差异均无统计学意义(P>0.05);而两组年龄、糖尿病、血脂异常、住院时间、吸烟等差异均有统计学意义(P<0.05)。多因素非条件Logistic回归结果显示,年龄、糖尿病、血脂异常、住院时间、吸烟均是慢性心衰患者发生心血管不良事件的独立危险因素(P<0.05)。结论慢性心衰患者的临床表现形式多样,应根据危险因素及时干预,以延缓疾病进展。Objective To discuss the clinical features and risk factors of cardiovascular adverse events(CVAE)in patients with chronic heart failure(CHF).Methods CHF patients(n=135)were chosen from People’s Hospital of Taihe County from Apr.2021 to Dec.2022.All patients were divided,according to follow-up results,into CVAE group(n=41)and non-CVAE group(n=94).The clinical materials were collected and clinical features were analyzed in CHF patients.The risk factors of CVAE were analyzed by using multi-factor Logistic regression model.Results The radio of male to female was 61:74.There were 32 cases of gradeⅡof NYHA,71 cases of gradeⅢof NYHA and 32 cases of gradeⅣof NYHA.The causes of CHF were mainly coronary heart disease(45.93%,62/135),hypertension heart disease(33.33%,45/135),dilated cardiomyopathy(12.59%,17/135),rheumatic heart disease(2.22%,3/135),chronic pulmonary heart disease(1.48%,2/135),congenital heart disease(1.48%,2/135)and other CVAE(2.96%,4/135).There were totally 41 cases of CVAE in all patients during follow-up period.The results of single-factor analysis showed that the differences in gender,body mass index(BMI),hypertension,heart rate,drinking,atrial fibrillation,systolic blood pressure,diastolic blood pressure,fasting plasma glucose,glycated hemoglobin and complicated diseases had no statistical significance(P>0.05),while the differences in age,diabetes,dyslipidemia,length of hospital stay and smoking had statistical significance between 2 groups(P<0.05).The results of multi-factor non-conditional Logistic regression analysis showed that age,diabetes,dyslipidemia,length of hospital stay and smoking were independent risk factors for CVAE in CHF patients(P<0.05).Conclusion The clinical manifestations are various in forms in CHF patients,so the risk factors should be intervened in time to delay disease development.

关 键 词：慢性心力衰竭 心血管不良事件 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]