某医院住院军队老干部慢性心力衰竭情况分析

目的：回顾调查解放军第四一一医院住院军队老干部慢性心力衰竭（chronic heart failure，CHF）住院诊疗情况，为制订该疾病的医疗保健对策提供相关依据。方法汇总2006－2015年因CHF入住解放军第四一一医院的201例军队老干部病历资料，回顾性分析其病因、诱因、诊断及治疗情况。结果老干部CHF病因排序依次为：冠心病（36．8％）、高血压性心脏病（31.3％）、糖尿病心肌病（12．9％）、肺源性心脏病（10．4％）以及其他（9．5％）；诱因排序依次为：感染（28．4％）、心律失常（23．4％）、治疗依从性差（17．9％）、心肌缺血（13．9％）、血压控制不佳（9．9％）以及其他（6．5％）；血浆脑利钠肽前体水平：86～95岁组高于76～85岁组，76～85岁组高于66～75岁组，差异有统计学意义（P＜0．05）；LVEF水平：86～95岁组低于76～85岁组，76～85岁组低于66～75岁组，差异有统计学意义（P＜0．05）；用药情况：服用洋地黄、ACEI／ARB、β受体阻滞剂、螺内酯等药物比例分别为：50．2％、49．3％、47．8％、45．8％。结论军队老干部CHF的防治需要进一步关注病因干预、诱因控制、规范治疗以及加强院外的综合管理。

Analysis of chronic heart failure among hospitalized veteran cadres

Objective To make a retrospective investigation on the diagnosis and treatment of the chronic heart failure ( CHF) among hospitalized veteran cadres , so as to provide scientific evidence for the development of health protection policies against the disease.Methods Totally, the medical records of 201 veteran cadres admitted into our hospital for treatment of CHF from 2006-2015 were collected , and then the causes , inducing factors , diagnosis and treatment of the disorder were analyzed statistically .Results The sequence of the causes of CHF was:coronary heart disease (36.8%), hypertensive heart disease (31.3%), diabetic cardiomyop-athy (12.9%), chronic pulmonary heart disease (10.4%) and other factors (9.5%).The sequence of the inducing factors was:in-fection (28.4%), arrhythmia (23.4%), poor treatment compliance (17.9%), myocardial ischemia (13.9%), poor control of blood pressure (9.9%), and other factors (6.5%).The level of NT-proBNP for the patients of the 86-95 age group was significantly high-er than that of the 76-85 age group, and the NT-proBNP level of the 76-85 age group was significantly higher than that of the 66-75 age group.The level of LVEF in the 86-95 age group was significantly higher than that of the 76-85 age group, and the level of LVEF in the 76-85 age group was significantly lower than that of the 66-75 age group .The medication of digitalis , ACEI/ARB, beta blockers and spironolactone drugs accounted for 50.2%, 49.3%, 47.8% and 45.8% respectively.Conclusion With regard to the prevention and treatment of CHF in the veteran cadres , special attention should be paid to the control of the pathogenic causes and indu -cing factors, the standardization of treatment , as well as comprehensive management of the disorder outside hospital .