老年心力衰竭186例临床剖析.docVIP

老年心力衰竭186例临床剖析 　　[摘要] 目的：探讨老年人心力衰竭的特点，为诊治老年心力衰竭提供依据。方法：将心力衰竭患者分成中青年组、老年组、高龄组三组，分别对其临床特点进行对比分析。结果：随着年龄的增加，心力衰竭患者为Ⅲ级和Ⅳ级的比例增加；引起心力衰竭的前三位病因分别为冠心病（63.2%）、肺心病（37.9%）、高心病（26.4%），老年组及高龄组常为2～3种疾病同时存在；各组心衰最常见的诱因是感染（58.7% ），心律失常（35.3%）也是一常见的诱因；老年患者心力衰竭症状、体征不典型，易致漏诊误诊；老年心力衰竭死亡率高（13.4% ）。结论：老年心力衰竭的主要病因为冠心病，年龄越大，临床症状越不典型，心力衰竭程度越重，预后越不良，治疗上要区别对待。 　　[关键词] 老年；心力衰竭；临床特点 　　[中图分类号]R541.6[文献标识码]A [文章编号]1673-7210（2008）07（a）-056-03 　　 　　A clinical analysis of elderly patients with heart failure in 186 cases 　　ZHOU Li-hua，ZHANG Zhi-qing，KANG Lin，LIU De-lin 　　(The Peoples Hospital ofYaan City，Yaan625000，China) 　　[Abstract] Objective: To explore the clinical characteristics of elderly patients with heart failure(HF) by analyzing different age-groups clinical data．Methods:269 cases with heart failure were divided into＜60 yearsgroup，60～74 years group and ≥75 years group. Their clinical features were compared and analyzed statistically.Results: With aging, the ratio of NYHA heart function Ⅲ、Ⅳ was significantly increased; the first three diseases which cause HF were coronary heart disease(63.2％)，pulmonary heart disease(37.9%) and hypertension(26.4％) ,however，2～3 diseases above usually coexisted in elderly and senilepatients; the most important cause was infection of HF（58.7%） in all the three age-groups，the arrhythmias（35.3%）in the elderly and senilepatients was also played an important part in causing HF; symptoms and signs were not typical in elderly group and senile group，so the disease often omitted and misdiagnosed; the death in elderly group and senile group (13.4％) increased compared withthe other age-groups．Conclusion:The older the patients are，the less typical clinical characteristics are，the more serious complication is，the more poor the prognosis is． 　　[Key words] Heart failure; Aged; Clinical features 　　 　　随着我国人口的老龄化，老年医学越来越受到广泛的重视。由于60岁以上的老年人生理自然老化，兼有多系统慢性疾病及其他脏器功能不同程度减退，使原有心脏病的老年患者心力衰竭的发病率与病死率不断增加，且症状常常隐匿而不典型。我院2003年1月～2007年8月收治的心力衰竭(CHF)患者269例，其中老年CHF186例，比较了各年龄组临床特点及治