| 靳松,张俊,唐杨琛,王璐,顾朋颖,沈干.住院心力衰竭患者的临床特征和预后的研究[J].中国临床保健杂志,2023,26(3):397-402. |
| 住院心力衰竭患者的临床特征和预后的研究 |
| Clinical characteristics and prognosis of inpatients with heart failure |
| 投稿时间：2023-05-15 |
| DOI：10.3969/J.issn.1672-6790.2023.03.025 |
| 中文关键词: 心力衰竭 每搏输出量 体征和症状 住院病人 预后 |
| 英文关键词: Heart failure Stroke volume Signs and symptoms Inpatients Prognosis 〖FL |
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| 中文摘要: |
| 目的 探讨不同射血分数的心力衰竭患者的临床特点和出院时的结局差异。方法 收集2019年9月1日至30日在四川大学华西医院住院的心力衰竭患者病历资料。入组后根据住院期间心脏彩色多普勒超声提示的射血分数(LVEF)将入组患者分为射血分数保留的心力衰竭(HFpEF,LVEF≥50%)、射血分数中间值的心力衰竭(HFmrEF,40%≤LVEF<50%)和射血分数下降的心力衰竭(HFrEF,LVEF<40%)3组,分析各组间的临床特征及出院时的结局情况。结果 共纳入468例住院心力衰竭患者,HFpEF组,HFmrEF组和HFrEF组各322例,78例和68例。HFrEF组的年龄在3组中最高,为(65.4±12.9)岁,3组间的年龄差异有统计学意义。男性在HFrEF组的占比较其他2组明显升高,为76.5%,P=0.029。对心力衰竭病因的分析中发现,HFpEF组的高血压性心脏病患者占比较其他2组更高,为16.8%,P=0.003,而HFrEF组的扩张性心肌病的占比较其他2组更高为11.8%,P<0.001；对患者相关病史的统计提示,慢性阻塞性肺疾病在HFpEF组中的占比较其他2组显著升高(18.9%,P=0.003)。3组患者本次出院时的结局情况差异无统计学意义。左室舒张末期内径、用药个数、共病情况是HFpEF患者出院时结局差异的影响因素。结论 不同射血分数的住院心力衰竭患者在年龄、心力衰竭病因以及合并疾病等临床特点中均存在显著差异,但是出院时的结局情况在各组间差异无统计学意义。为了更好的预测患者预后,可能需要引入新的变量对心力衰竭进行分类。 |
| 英文摘要: |
| Objective To investigate the inpatients′ clinical characteristics and prognosis of heart failure patients with different ejection fraction.Methods Patients with heart failure admitted to West China Hospital of Sichuan University from September 1 to 30,2019 were retrospectively collected.According to the lowest ejection fraction indicated by echocardiography,the patients were divided into three groups:heart failure with preserved ejection fraction (HFpEF,LVEF≥50%),heart failure with middle ejection fraction (HFmrEF,40%≤LVEF<50%) and heart failure with decreased ejection fraction (HFrEF,LVEF<40%).Results Total of 468 hospitalized heart failure patients were included,including 322 HFpEF patients,78 HFmrEF patients and 68 HFrEF patients.The average age of HFrEF group was (65.4±12.9) years old,there was statistical difference among the three groups.The proportion of male in HFrEF group was significantly higher than that in the other two groups (76.5%,P=0.029).In the analysis of the causes of heart failure,the proportion of patients with hypertensive heart disease in HFpEF group was 16.8%,higher than that in the other two groups (P=0.003),while the proportion of patients with dilated cardiomyopathy in HFrEF group was 11.8%,higher than that in the other two groups (P<0.001).According to the medical history of patients,the proportion of COPD in HFpEF group was significantly higher than that in the other two groups (18.9%,P=0.003).There was no significant difference in the outcome of hospitalization among the three groups.LV,number of medications and comorbidification are prognostic factors of HFpEF patients.Conclusions There are significant differences in age,etiology of heart failure and co-morbidities among hospitalized patients with different ejection fractions,but there is no significant difference in hospitalization outcomes among all groups.In order to better predict the prognosis of patients,it may be necessary to introduce new variables to classify heart failure. |
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