继续医学教育Issue(12)：68-71,4.DOI:10.3969/j.issn.1004-6763.2015.12.042
多次急性发作心力衰竭患者特性及院内死亡分析
Analysis on the Characteristics and In-hospital Mortality for Heart Failure Patients With Several Acute Exacerbation
摘要
Abstract
ObjectiveTo investigate characteristics and in-hospital cardiac mortality for different type of heart failure patients with several acute exacerbation.Methods Collecting the medical records in Fuxing hospital, Capital medical University between January 2008 to May 2013, Only the heart failure patients with two or more acute exacerbation were chosen. According to left ventricular ejection fraction (LVEF), they were divided into three groups: patients with LVEF≤40%, LVEF 40.1% to 49.9% and LVEF≥50%. History ,clinical data, and in-hospital cardiac mortality(deterioration of heart failure, arrhythmia, myocardial infarction, sudden death )were collected.ResultsA total 307 patients were recruited. 162 men(52.8%) and 145 women(47.2%). The mean age was (75.9±10.2) year old, mean frequency of hospitalization was (2.3±0.7), 138 patients with LVEF≤40%,92 patients with LVEF 40.1% to 49.9% and 77 patients with LVEF≥50%, history was almost similar between patients with LVEF≥50% and LVEF 40.1% to 49.9%, compared with patients with LVEF≤40%, patients with LVEF≥50% were elderly (P<0.001) and had less frequency of hospitalization as well as blood pressure monitoring, more history of smoking, chronic obstructive pulmonary diseases (COPD) and atrial ifbrillation (Af), lower levels of brain natriuretic peptide (BNP) (P<0.05), patients with LVEF40.1% to 49.9% were elderly (P<0.001) and had less frequency of hospitalization as well as blood pressure monitoring, more history of diabetes, lower levels of hemoglobin (P<0.05), with the decreasing of LVEF, there were more males (P=0.001),more myocardial infarction, larger of left ventricular diastolic diameters, higher levels of uric acids (P<0.001). 29 patients were died in hospital, 14 patients with LVEF≤40% (10.1%),9 patients with LVEF 40.1% to 49.9% (9.8%) , 6 patients with LVEF≥50% (7.8%), there was no statistical difference among the three groups (χ2=0.5,P>0.05), the independent factors for mortality included the frequency of hospitalization, COPD, Af and BNP.ConclusionDifferent types of heart failure have not the same characteristics. Heart failure patients with preserved LVEF also have similar in-hospital cardiac mortality than patients with reduced LVEF when they suffer from several acute exacerbation. Management should be paid attention to patients with preserved LVEF.关键词
心力衰竭/射血分数保留性心力衰竭/射血分数下降性心力衰竭/急性发作/死亡Key words
Heart failure/Preserved ejection fraction/Reduced ejection fraction/Acute exacerbation/Mortality分类
医药卫生引用本文复制引用
尹朝霞,肖涛,陈瑒,蔡澍..多次急性发作心力衰竭患者特性及院内死亡分析[J].继续医学教育,2015,(12):68-71,4.基金项目
首都卫生发展科研专项资助项目 （）
