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目的分析慢性心力衰竭合并心房颤动住院病例的特点。方法采用2中心、回顾性、对照研究。对病例在年代(Ⅰ、Ⅱ、Ⅲ组)、性别、年龄分期等方面的特点进行分析。结果入选1 410例,年龄呈现老龄化(P<0.01)。心功能以NYHAⅢ、Ⅳ级为主,占87.9%。Ⅰ和Ⅱ组的首位病因是风湿性心脏病,Ⅲ组则是冠心病。随着年龄的增加,女性患者心房颤动比例减少。老年前期首位病因是风湿性心脏病,老年期和高龄老年期则为冠心病。总的好转率82.9%,总的病死率12.6%,后者以Ⅲ组最低(P<0.01)。死亡病例的首位病因逐渐由风湿性心脏病演变为冠心病,死因以非心脏性原因死亡居多,其次为心功能恶化。结论慢性心力衰竭合并心房颤动住院病例的首位病因从风湿性心脏病演变为冠心病;高龄、冠心病合并心房颤动可能逐渐成为慢性心力衰竭的主要流行趋势。
Objective To analyze the characteristics of hospitalized patients with chronic heart failure and atrial fibrillation. Methods 2 centers, retrospective, controlled study. The characteristics of the cases in the age (Ⅰ, Ⅱ, Ⅲ group), gender, age staging and other aspects were analyzed. Results A total of 1 410 cases were enrolled in this study. The age was aging (P <0.01). NYHA Ⅲ, Ⅳ grade of heart function, accounting for 87.9%. The first cause of group Ⅰ and Ⅱ was rheumatic heart disease, while group Ⅲ was coronary heart disease. With age, the proportion of women with atrial fibrillation decreased. The first cause of pre-senile rheumatic heart disease, senile and elderly coronary heart disease. The overall improvement rate was 82.9% and the overall mortality rate was 12.6%. The latter was the lowest in group Ⅲ (P <0.01). The first cause of death gradually evolved from rheumatic heart disease to coronary heart disease. The cause of death was mostly non-cardiac causes, followed by worsening cardiac function. Conclusion The first cause of hospitalized cases of chronic heart failure with atrial fibrillation evolved from rheumatic heart disease to coronary heart disease. In elderly patients, coronary heart disease with atrial fibrillation may gradually become the main epidemic trend of chronic heart failure.