Abstract：Objective: To analyze the clinical features of heart failure with multiple etiological factors in seniors, so as to provide scientific basis for clinical prevention and treatment. Methods: A retrospective analysis was made on hospitalized medical records of heart failure patients aged 60 or above in our hospital. According to the number of etiological factors divided into single-cause group, double-cause group and multi-cause group were compared to summarize the clinical characteristics of multi-cause heart failure. Results: A total of 249 cases of senile heart failure were collected, of which there were 83 cases of single pathogeny group, 79 cases of two pathogenesis group and 87 cases of multiple pathogenesis group. The most common combination of double pathogenesis was coronary heart disease and hypertension (28 cases, 35.4%). There were 46 cases (52.9%) with three etiological factors and 34 cases (39.1%) with four etiological factors in the multi-etiological group. The indexes of age, NYHA class III-IV, brain natriuretic peptide (BNP) elevation, hospitalization time and the number of drugs taken in the two groups were significantly higher than those in the single-cause group, while those in the multi-cause group were significantly higher than those in the double-cause group (age F=53.05, P<0.01; cardiac function class χ2=15.83, P<0.01; brain natriuretic peptide χ2= 18.58, P<0.01). Hospitalization time F=28.61, P<0.01; medication type F = 18.81, P<0.01; hospitalization mortality increased with the increase of etiology, but no statistical difference was found (χ2=1.823, P=0.twin). Conclusion: The heart failure with multiple etiological factors in seniors are many with advanced age with comorbid diseases. The state of an illness and its treatment were complication as well as the hospital stays were prolonged with a poor prognosis.
[1] 王士雯,吴海云.老年人多病因心力衰竭:多种病因和合并疾病在老年人心力衰竭发生和发展中的作用[J].中华老年多器官疾病杂志,2007,6(6):373~376. [2] 裴志勇,赵玉生,李佳月,等.慢性心力衰竭住院患者病因学及近期预后的15年变迁[J].中华心血管病杂志,2011,39(5):434~439. [3] Kushner FG, Hand M, Smith SC Jr, et al. 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of theAmerican College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J].Am Coll Cardiol,2009, 54(23):2205~2241. [4] Moore KL, Boscardin wJ, Steinman MA, et a1. Patterns of chronic co-morbid medical conditions in older residents of U.S. nursing homes: differences between the sexes and across the agespan[J].Nutr Health Aging, 2014,18(4):429~436. [5] Marengoni A1, Rizzuto D, Wang HX, et al. Patterns of chronic multimorbidity in the elderly population[J].Am Geriatr Soc, 2009,57(2):225~230. [6] Braunstein JB,Anderson GF,Gerstenblith G,et a1. Noncardiac comorbidity increases preventable hospitalizations and mortality among Medicare beneficiaries with chronic heart failure[J].Am Coil Cardiol, 2003,42(7):1226~l233. [7] 赵玉生,李宗斌,李佳月,等.老年心力衰竭住院患者6288例的病因变迁[J].中华老年多器官疾病杂志,2014,13(9):643~647 [8] Adams KF Jr,Fonarow GC.Emerman CL,et a1.Characteristics and outcomes of patients hospitalized for heart failure in the United States:rationale, design, an d preliminary observations from the flint 100 000 cases in the Acute Deeompensated Heart Failure National Registry (ADHERE)[J].Am Heart, 2005,149(2):209~216. [9] 吴立荣.慢性心力衰竭的病因学演变[J].医学与哲学,2012,34 (6):14~15. [10] 中国心力衰竭诊断和治疗指南2014[J].中华心血管杂志,2014,42(2):98~122.
2018, Vol. 24 
冀公网安备13080202000786号