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目的:探讨老年危重症患者心力衰竭患病率、心力衰竭特点及危险因素。方法:收集2011-12-2014-09我院急诊内科和急诊ICU收治的老年危重症患者216例,回顾性分析老年危重症患者心力衰竭患病率及其特点,并采用多元Logistic回归分析筛选老年危重症患者发生心力衰竭的独立危险因素。结果:216例患者中,59例(27.3%)患者合并心力衰竭,且31例合并心力衰竭患者的左室射血分数(LVEF)≥50%;合并心力衰竭患者的平均年龄明显高于无合并心力衰竭患者[(75.4±10.2)岁vs.(72.0±14.9)岁,t=6.447,P=0.015];左室收缩功能正常的心力衰竭患者平均年龄明显高于左室收缩功能不全的心力衰竭患者[(76.7±9.3)岁vs.(74.3±8.4)岁,t=5.624,P=0.036];多元Logistic回归分析显示,冠心病(OR=8.271,95%CI:5.916~10.821,P=0.000)、瓣膜性心脏病(OR=7.961,95%CI:4.871~11.226,P=0.002)、糖尿病(OR=2.061,95%CI:1.176~3.812,P=0.009)、呼吸衰竭(OR=1.443,95%CI:0.975~2.118,P=0.038)以及肾功能不全(OR=2.038,95%CI:1.661~2.464,P=0.016)均显著增加老年危重症患者心力衰竭发病风险。结论:心力衰竭已成为老年危重症患者不容小觑的问题,通过对老年危重症患者心力衰竭特征及其危险因素进行研究,有助于老年危重症患者的临床救治。
Objective: To investigate the prevalence of heart failure in elderly critically ill patients, the characteristics of heart failure and risk factors. Methods: A total of 216 elderly critically ill patients admitted to our emergency department and emergency ICU from Dec 2011 to Sep 2014 were retrospectively analyzed. The prevalence and characteristics of heart failure in elderly critically ill patients were retrospectively analyzed. Multivariate Logistic regression analysis was used to screen the elderly Independent risk factors for heart failure in critically ill patients. Results: Of the 216 patients, 59 (27.3%) patients had heart failure, and 31 patients with congestive heart failure had a LVEF ≥50%. The mean age of patients with heart failure was significantly higher than that of patients without concomitant (75.4 ± 10.2) years vs. (72.0 ± 14.9) years, t = 6.447, P = 0.015). The average age of patients with normal left ventricular systolic function was significantly higher than that of patients with left ventricular systolic dysfunction (76.7 ± 9.3) vs. (74.3 ± 8.4) years, t = 5.624, P = 0.036). Multiple logistic regression analysis showed that coronary heart disease (OR = 8.271,95% CI 5.916-10.821, P = 0.000 (OR = 7.961, 95% CI: 4.871-11.226, P = 0.002), diabetes (OR = 2.061, 95% CI: 1.176-3.812, P = 0.009), respiratory failure 95% CI: 0.975-2.1180, P = 0.038) and renal insufficiency (OR = 2.038,95% CI: 1.661-2.464, P = 0.016) significantly increased the risk of heart failure in elderly critically ill patients. CONCLUSION: Heart failure has become a critical issue for critically ill elderly patients. By studying the characteristics and risk factors of heart failure in elderly critically ill patients, it is helpful for the clinical treatment of elderly critically ill patients.