摘要
目的 调查上海地区 1 980、1 990、2 0 0 0年 3个年度非定群心力衰竭住院患者病因谱、流行病学特点和药物治疗 3个方面的状况及演变。方法 采用回顾性病史分析方法 ,按年度进行统计对比。入选的调查对象必须同时具备以下 3项 ,即 1 980、1 990、2 0 0 0年出院病例 ;临床诊断为充血性心力衰竭 ;至少具有 1项或 1项以上心血管异常的客观指标。结果 共调查 2 1 78例心力衰竭患者 ,2 371例次。男性患者多于女性。住院年龄 (64 0± 1 6 0 )岁 ,2 0年内平均年龄由 51 5岁上升至 68 8岁(P <0 0 0 0 1 )。病因谱显著变化 ,2 0年内风湿性瓣膜病由 46 8%降至 8 9% ,冠心病由 31 1 %上升至55 7% (P <0 0 0 0 1 )。3个年度比较 ,住院死亡率及平均年急诊、住院次数均有显著下降 (P <0 0 0 0 1 )。共有死亡 1 96例 ,多数死于心力衰竭进行性恶化 ,非预期猝死仅 8 6 %。药物治疗现状仍以传统治疗为主 ,血管紧张素转换酶抑制剂、β 受体阻滞剂的应用近年来均有增长 ,但仍未被充分使用。结论 近年来心力衰竭治疗方面的进步令人瞩目 。
Objective To investigate the evolution and status in the epidemiologic factors and treatment of Shanghai hospitalized patients with congestive heart failure during the years of 1980,1990 and 2000 Methods Hospital records with diagnosis of congestive heart failure in association with at least one abnormal finding for cardiovascular disease during these three years were scrutinized Data was analysed as multiple section of non cohort study Results In 2 371 episodes of hospitalization of 2?178 cases, the mean age was (64 0±16 0) years old From 1980 to 2000, the average age increased from 51 5 to 68 8 years old( P <0 000?1) The etiology of heart failure was also shifted significantly from rheumatic valvular disease to coronary heart disease during the past two decades The hospital mortality as well as average time of hospitalization per year were both declined from 1980 to 2000 ( P < 0 000?1) The major mode of death was progressive heart failure and sudden death rate was only 8 6% The medical treatment mainly remained conventional Administration of angiotensin cenversion enzyme inhibitor (ACEI) and β blocker promptly increased during recent ten years, but was not adequate Conclusion Heart failure clearly represents an enormous clinical problem and a major social burden The advances in therapy of heart failure should be implemented in clinical practice
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2002年第1期24-27,共4页
Chinese Journal of Cardiology
