摘要
目的 对比分析不同年龄心力衰竭常见的临床特点 ,为临床诊断和治疗老年心力衰竭提供依据。方法 将70 4例 4 5岁以上心力衰竭患者按年龄分为 3组 ,4 5～ 5 9岁为老年前期组 ,6 0～ 79岁为老年组 ,80岁以上为高龄组。分别对其临床表现进行对比分析。结果 不同年龄组心衰各有特点 ,随着增龄 ,出现多方面的不同 :①舒张性心衰及心源性休克的比例亦显著增加 ;②年龄越大 ,症状越不典型 ;③随着增龄 ,心脏增大的比例逐渐降低 ,单纯心率增快比例显著增加 ;肺部阳性体征明显增加 ,哮鸣音和湿罗音的比例显著增多 ;④辅助检查的阳性率逐渐增加 ,尤其是高龄心衰肺部X线检查、心电图Ptf-V1阳性对早期诊断和治疗有很大帮助 ;⑤肺、肾、脑、消化道、各种栓塞等并发症显著增加。结论 不同年龄心衰临床表现各具特点 ,年龄越大 ,临床表现越不典型 ,尤其是高龄老人 ,一旦出现心衰 ,往往起病急、病情重 ,易在短期内并发重要脏器严重并发症 ,预后不良 ;早期辅助检查对高龄心衰诊断有较大帮助 ;不同年龄心衰治疗应区别对待。
Objective To find out the characteristics of the heart failure in different age group in order to offer some help for the diagnosis and treatment of the heart failure. Methods 704 heart failure patients were divided into three groups according to age. Patients aged 45～59 were presenile group, those aged 60～79 were old group, while those over 80 were very old group. The clinical manifestations were analyzed comparatively. Results The analysis showed that the clinical manifestations deffered very much with age increasing:①Chronic heart failure became less common while severe heart failure and cardiogenic shock became more frequent; The proportion of diastolic heart failure and the left heart failure increased especially acute left heart failure and attacks of chronic heart failure; Condition of the very old heart failure patients were seen to be very severe and critical; ②Symptoms became atypical, proportion of typical exertive and nocturnal dyspnea was less than that in the presenile and the old group significantly, while nonspecific cough, excessive sputum and sense problems were more frequent; ③Proportion of heart enlargement was decreased but that of isolated heart rate increasing became more frequent. Positive signs in lungs became remarkable especially dry and moist rales; ④Lungs X-ray examinations and other examinations such as ECG were helpful for the early diagnosis in old heart failure; ⑤Complications of the pulmonary renal functions and thrombosis were more frequent. Conclusions Manifestations of heart failure in the old patients were often atypical, especially in the very old patients. The old patients were liable to complicated with many severe complications such as pulmonary renal functions, sense problems and so on. The prognosis was often bad. The therapy should also varied accordingly.
出处
《中国急救医学》
CAS
CSCD
北大核心
2002年第9期516-518,共3页
Chinese Journal of Critical Care Medicine
