老年舒张性心力衰竭的临床特点分析

目的：分析老年舒张性心力衰竭（DHF）发病的临床特点。方法对2012年3月至2013年12月我科收治的57例临床诊断为舒张性心力衰竭患者临床资料进行回顾性分析，通过生化检查、B型脑钠肽（BNP）水平测定、超声心动图、心电图、全胸片等检查，对DHF患者的BNP水平、心超特点以及基础疾病进行分析。结果 DHF患者的BNP水平明显增高，平均值为594．7 pg/mL（正常值＜100 pg/mL），心脏超声特点为左心房明显增大占84．2％，平均值为44．6 mm，肺动脉压升高占71．9％，平均值48．5 mmHg，室间隔肥厚的患者占19．3％，平均值10．4 mm，左室后壁增厚占8．7％，平均值9．7 mm，LVEF大致正常；心电图检查房颤占56．1％，所患基础疾病：心房颤动、高血压病、冠心病、糖尿病分别占56．1％、66．7％、47．3％和21．1％。结论心房颤动、高血压病、冠心病、糖尿病等疾病可能是发生DHF的主要病因，心超检查和BNP水平监测、心电图检查是诊断DHF的重要手段。

The clinical features of diastolic heart failure incidence in elderly patients

Objective To analyse the clinical features of the incidence of elderly diastolic heart failure.Methods There were 57 cases of patients with a clinical diagnosis of diastolic heart failure,and the data were analyzed retrospectively in the Department of Vasculocar-diology of the Hospital from March 2012 to December 2013.All patients were conducted biochemical tests,BNP levels,echocardiography, chest X-ray and other tests.The levels of BNP,echocardiographic characteristics for patients with DHF and underlying diseases were ana-lyzed.Results The levels of BNP were significantly higher in patients with DHF,with the average of 594.7 pg/mL （normal〈100 pg/mL）. The echocardiographic features suggestive of left atrium significantly increased 84.2% with an average of 44.6 mm in the group of patients with DHF,pulmonary hypertension （71.9%）,with the average of 48.5 mmHg,septal hypertrophy in 19.3%,with the mean of 10.4 mm,left ventricular posterior wall thickening （8.7%）,with the average of 9.7 mm,and the EF was normal.ECG atrial fibrillation prompted 56.1%, the patients with DHF suffering from underlying diseases such as atrial fibrillation,hypertension,coronary atherosclerotic heart disease,diabe-tes,which accounted for respectively 56.1%,66.7%,47.3%and 21.1%.Conclusion The disease of atrial fibrillation,hypertension,coro-nary atherosclerotic heart disease,diabetes may be reasons of DHF.Echocardiography,BNP levels and ECG will be important means for the diagnosis of DHF.