摘要
目的:分析心力衰竭住院死亡病例的病因变化、临床特点、死亡方式、死亡时间,为心力衰竭的防治提供依据。方法:采用回顾性病史分析方法,根据死亡病例病因及治疗的变化,分为2个时段进行比较分析。结果:①死亡病例的病因以冠心病和风湿性心脏瓣膜病为主,分别为52.0%和28.3%;随时段的发展,风湿性心脏瓣膜病的比例明显下降(36.2%∶20.3%,P<0.01),冠心病的比例显著增加(43.4%∶60.8%,P<0.01),主要是由于心肌梗死后心力衰竭的增加(15.8%∶32.4%,P<0.01);②死亡年龄趋于向高龄化发展,并发原发性高血压、糖尿病、陈旧性心肌梗死的比例随时段明显增加(P<0.05或0.01),分别为28.3%∶39.2%、10.5%∶23.6%、17.1%∶31.8%、13.8%∶30.4%;③住院期间药物应用以利尿剂、洋地黄类和硝酸酯类为主,总体应用比例分别为83.3%、81.7%、85.0%,ACEI和β受体阻滞剂使用上升,分别由时段1的44.1%、5.9%升至时段2的60.1%和12.8%;④死亡方式依次为,泵衰竭死亡131例(43.7%),猝死88例(29.3%),其他并发症死亡81例(27.0%);⑤死亡月份有统计学意义,集中于1月份。结论:心力衰竭住院死亡病例的病因以冠心病和风湿性心脏瓣膜病为主,随时段的发展,冠心病的比例明显上升,主要是心肌梗死后心力衰竭的增加;泵衰竭和猝死是心力衰竭的主要死亡方式;
Objective:To analyze the major causes, clinical characteristics, mode of death and death time of the hospitalized death cases with chronic heart failure (CHF), and to provide more information on the prevention and treatment strategy of CHF. Method:A retrospective study was used. Result:The two major causes of CHF were Coronary Heart Disease (CHD) and Rheumatic Heart Disease (RHD), with 52.0% and 28.3% respectively. The proportion of RHD decreased significantly (36.2%vs 20.3%, P< 0.01) and CHD increased significantly (43.4% vs 60.8%,P< 0.01)between the two stage.②the patients were older, the proportion of cases with a history of hypertension, diabetes mellitus, OMI increased significantly over time (P< 0.05). ③In terms of pharmacological treatment during hospital, the diuretics, digitalis and nitride dominated, with the total proportion of 83.3%, 81.7% and 85.0%; the use of ACEI, β-blocker increased significantly over time (P< 0.05).④The two main mode of death were pump heart failure (43.7%) and sudden cardiac death (29.3%). ⑤The death months were significantly cumulative in January. Conclusions:①CHD and RHD were the two major causes of HF which cases died of, the proportion of CHD increased significantly over time, mainly because of the increase of HF caused by MI; Pump failure and sudden cardiac death were the major mode of death with HF; There was significant difference with death time, the peak time was in winter.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2005年第5期266-269,共4页
Journal of Clinical Cardiology
基金
天津市科委科技发展项目(编号:033111311)
关键词
心力衰竭
住院死亡
死亡原因
Heart failure
Hospitalized death
Mode of death
