老年人心力衰竭91例临床分析

目的探讨老年人心力衰竭的临床特点。方法回顾性分析91例老年人心力衰竭临床资料,与21例中青年人心力衰竭进行对比分析。结果(1)随着年龄的增加,NYHA心功能Ⅲ、Ⅳ的比例显著增加;(2)引起心力衰竭前3位病因分别为冠心病(67.9%)、高血压病(32.1%)、肺心病(26.8%),老年组及高龄组常为2-3种疾病并存;(3)各年龄组心力衰竭最常见的诱因是感染(59.8%),高龄组心律失常(51.4%)也是重要的诱因;(4)老年及高龄组症状、体征常不典型,易致漏诊误诊;(5)高龄组并发脑梗死(25.7%)、心律失常-房颤(34.3%)及死亡(17.4%)的比例增加。结论年龄越大,临床表现越不典型,病情越危重,并发症越多,预后不良。

A clinical analysis of elderly patients with heart failure in 91 cases

Objective To explore the clinical characteristics of elderly patients with heart failure(HF) by analyzing different age-groups' clinical data.Methods91 cases of clinical history recored of elderly people with HF were reviewed and then made a comparison with the young and moderate patients with HF.Result(1) With aging,the ratio of NYHA heart function Ⅲ、Ⅳ was was significantly increased.(2) The first three diseases which cause HF were coronary heart disease(67.9%)、hypertension(32.1%)、pulmonary heart disease(26.8%),however,two-three diseases above usually coexisted in elderly and senile patients.(3) The most important cause was infection of HF in all the three age-groups,but as for senile patients,the arrhythmias was also play an important part in causing HF.(4) Symptoms and signs were not typical in elderly group and senile group,so the disease was often omitted and misdiagnosed.(5) The incidence rates of cerebral infarction(25.7%)、arrhythmias-atrial fibrillation(34.3%) and death(17.4%) in senile group were more significantly increased compared with those of the other two age-groups.ConclusionThe older the patients is,the less typical clinical characteristics are,the more serious complication is,the more poor the prognosis is.