慢性心力衰竭患者20年内病因构成及病死率的变化

姜晓宇; 赵晓云; 张东海; 王宁勃

慢性心力衰竭患者20年内病因构成及病死率的变化

Changes of etiology and mortality in patients with chronic heart failure: 20year study

摘要

摘要: 目的:调查铜川地区1990、2000、2010年3个年度慢性心力衰竭（CHF）住院患者病因构成和病死率的变化趋势。方法：采用回顾性病史分析方法，按年度统计对比。入选的调查对象为确诊CHF住院患者。结果:共调查2 476例患者。男性多于女性。住院年龄（60±17）岁，20年中3个时间段住院年龄依次分别为（52±16）岁、（59±17）岁、（64±15）岁，逐渐增大（P<0.05）。病因学显著变化，冠心病由356%递升至49.2%，风湿性心脏瓣膜病从35.2%降低16.6%（均P<0.05），冠心病、高血压、糖尿病呈增长趋势。风心病呈下降趋势。3个年度住院病死率依次为6.9%、4.5%、5.1%，其中后两个10年的病死率均低于1990年时间段（P<0.05）。近10年由冠心病引起心衰的病死率由1990年的9%下降至2010年的4%，较高血压病、风心病、糖尿病、肺心病下降最明显（P<0.05）。并发糖尿病患者病死率均明显高于不并发糖尿病者。结论:30年来心衰病因构成主要是冠心病、高血压病、糖尿病、肺心病和风心病为主，前四者递增趋势明显，风心病呈下降趋势。病死率呈下降趋势。冠心病病死率下降最明显。

Abstract: AIM:To investigate the etiologies and mortalities in patients with chronic heart failure during the years of 1990, 2000 and 2010. METHODS: Hospital records with a diagnosis of congestive heart failure during these 3 years were analyzed. RESULTS: In the 2 476 cases under study, the mean age was (60±17) years and the mean ages for 1990, 2000 and 2010 were, respectively, (52±16) years, (59±17) years and (64±15) years, with an increasing tendency (P<0.05). Significant etiological changes showed that the rate of coronary heart disease rose from 356% to 492%, whereas rheumatic valvular heart diseases declined from 35.2% to 16.6% (P<0.05). During these 3 years, mortality rates were, respectively, 6.9%, 4.5% and 5.1% and the mortalities of heart failure in 2000 and 2010 were lower than in 1990 (P<0.05). The mortality of heart failure decreased most dramatically in the last 10 years. CONCLUSION: Coronary heart disease, hypertension, diabetes mellitus and rheumatic valvular heart disease are the primary diseases causing heart failure during the period from 1990-2010, with the former three diseases exhibiting an upward trend and the last one a downward trend.The mortality exhibits a downward trend and decreases most significantly in patients with coronary heart disease.

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