慢性心功能不全患者长期预后的性别差异-中国循环杂志.PDFVIP

948 中国循环杂志 2017 年 10 月 第 32 卷 第 10 期（总第 232 期）Chinese Circulation Journal，October，2017，Vol. 32 No.10（Serial No.232） 心力衰竭研究 慢性心功能不全患者长期预后的性别差异 闫妍，于彤彤，孙兆青，孙志军 摘要 目的：探讨慢性心功能不全患者长期预后的性别差异。 方法：连续入选 925 例慢性心功能不全住院患者，其中女性 460 例（49.7%），平均随访 3.4 年，以全因死亡为终点， 通过 Cox 回归分析慢性心功能不全患者长期预后的性别差异。 结果：随访期间，整体全因死亡率 27.9%，女性死亡率 25.2%，男性死亡率 30.5%。多因素 Cox 回归分析显示， 男性患者的长期死亡风险要比女性患者高（HR=1.309，95% CI：1.002~1.708； P =0.048）。亚组分析显示，在年龄≥ 65 岁亚组、左心室射血分数（LVEF）＜ 45% 亚组、心功能Ⅲ、Ⅳ级亚组，女性的长期预后要显著好于男性。 结论：女性慢性心功能不全患者的长期预后要显著好于男性；而且年龄≥ 65 岁、LVEF45%、心功能Ⅲ、Ⅳ级 的女性患者的预后较好。 关键词 心力衰竭；预后；性别因素 Gender Differences for Long-term Prognosis in Patients With Chronic Heart Failure YAN Yan, YU Tong-tong, SUN Zhao-qing, SUN Zhi-jun. Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang (110022), Liaoning, China Corresponding Author: SUN Zhi-jun, Email: sunzj_99@163.com Abstract Objective: To analyze gender differences for the long-term prognosis in patients with chronic heart failure (CHF). Methods: A total of 925 consecutive CHF patients admitted in our hospital were enrolled those including 460 (49.7%) female. The mean follow-up time was 3.4 years and the end point event was all-cause mortality. Gender differences for the long-term prognosis in CHF patients were studied by Cox proportional-hazards regression analysis. Results: The overall all-cause mortality was 27.9% during follow-up period, mortality in female was 25.2% and in male was 30.5%. Multivariate Cox regression analysis presented that the long-term death risk in male patients was higher than female (HR=1.309, 95% CI 1.002-1.708, P=0.048). Subgroup analysis showed that for patients age ≥65 years, LVEF45% and with NYHA grade III/IV, the long-te