天津医药 ›› 2015, Vol. 43 ›› Issue (1): 68-71.doi: 10.3969/j.issn.0253-9896.2015.01.018

• 临床研究 • 上一篇    下一篇

舒张性和收缩性心衰患者的临床表现差异分析#br#

于彤彤, 刘双双, 王菁菁, 王传合, 韩苏, 孙志军△#br#   

  1. 中国医科大学附属盛京医院心内科, 辽宁沈阳(邮编 110004
  • 收稿日期:2014-07-22 修回日期:2014-09-19 出版日期:2015-01-15 发布日期:2015-01-30
  • 通讯作者: 孙志军E-mail: sunzj_99@163.com E-mail:sunzj_99@163.com

Differences in clinical characteristics between patients with diastolic heart failure and systolic heart failure

YU Tongtong, LIU Shuangshuang, WANG Jingjing, WANG Chuanhe, HAN Su, SUN Zhijun△#br# #br#   

  1. Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang 110004, China

  • Received:2014-07-22 Revised:2014-09-19 Published:2015-01-15 Online:2015-01-30
  • Contact: E-mail: sunzj_99@163.com E-mail:sunzj_99@163.com

摘要: 目的 比较舒张性心功能衰竭(心衰)和收缩性心衰患者在临床表现及危险因素方面的差异。 方法 将 2 088 例心衰患者按左室射血分数(EF)分为舒张性心衰组(EF≥0.45, 1 356 例)和收缩性心衰组(EF< 0.45, 732 例),比较 2 组的临床资料, 分析影响 2 种心衰类型的相关因素。 结果 与收缩性心衰组相比, 舒张性心衰组的平均年龄更大, 女性及高血压的比例更高, 但低蛋白血症、贫血、肾功能不全、高尿酸血症的比例更低, 且以心功能Ⅰ 、Ⅱ 级为主; 收缩压、白蛋白、前白蛋白、胆固醇、血钠、血氯水平更高, 但心率更慢, 肌酐、血尿酸、血钾、脑钠肽水平更低。 与收缩性心衰组相比, 舒张性心衰组的左室舒末容积、左室缩末容积较低, RAS 阻断剂和β受体阻断剂使用率更低, 他汀类药物使用率更高。 Logistic 多因素回归分析发现, 性别、高血压对舒张性心衰影响更强;低蛋白血症、高尿酸血症则对收缩性心衰影响更强。 结论 舒张性心衰和收缩性心衰存在诸多差异, 不同类型的心衰需采取不同的诊治及预防方案。

关键词: 心力衰竭, 舒张性, 心力衰竭, 收缩性, 临床特点, 危险因素

Abstract: Abstract:Objective To analyze the differences in clinical characteristics and risk factors in patients with diastolic heart failure and systolic heart failure. Methods A total of 2 088 patients with heart failure were divided into two groups, diastolic heart failure group (EF≥0.45, n=1 356) and systolic heart failure group (EF<0.45, n=732), according to ejection fraction (EF). The clinical features and related factors affecting the two types of heart failure were compared between two groups. Results There were higher age, higher proportion of women and higher proportion of hypertensive patients in dia⁃ stolic heart failure group than those of systolic heart failure group, but lower rates of hypoalbuminemia, anemia, renal insuffi⁃ ciency and hyperuricimia. There was higher incidence of functional class I and II in diastolic heart failure group. And com⁃ pared with systolic heart failure group, there were higher levels of systolic blood pressure, albumin, prealbumin, cholesterol, sodium and serum chloride in diastolic heart failure group, but lower levels of heart rates, creatinine, blood uric acid, potassi⁃ um and brain natriuretic peptide. Compared with systolic heart failure group, there were lower left ventricular end diastolic volume (LVEDV) and left ventricular end systolic volume (LVESV) in diastolic heart failure group. And there were lowerRAS blocker and β-blocker usage, higher statin usage in diastolic heart failure group. Logistic regression analysis showed that gender and hypertension were significantly correlated with diastolic heart failure, and hypoalbuminemia and hyper⁃ uricimia were significantly correlated with systolic heart failure. Conclusion Our results show that there are differences in clinical features and risk factors in patients with diastolic heart failure and systolic heart failure. We should take the differ⁃ ent treatment and prevention programs for the two kinds of heart failures.

Key words: heart failure, diastolic;heart failure, systolic;clinical characteristics, risk factorscharacteristics, risk factors