老年冠心病慢性心力衰竭并发电解质紊乱的临床特点

目的探讨老年冠心病慢性心力衰竭（CHF）并发电解质紊乱病人的临床特点。方法回顾分析2004年7月-2007年3月间收治的102例老年冠心病CHF并发电解质紊乱病人的临床资料。结果随着心力衰竭程度的加重,老年冠心病CHF病人电解质紊乱的发生率增加,入院时血Na^＋和Cl^-水平降低,心功能Ⅳ级病人血Na^＋、Cl^-水平低于正常值,但不同心功能分级CHF病人间血K＋水平差异无统计学意义。在老年冠心病CHF并发电解质紊乱病人中,低Na^＋及低Na^＋＋低Cl-的发生率要远高于低K＋及低K^＋＋低Cl^-的发生率,同时并发低Na^＋、低K^＋、低Cl-者只见于心功能Ⅲ、Ⅳ级病人,未见于心功能Ⅱ级的病人。未用利尿剂病人电解质紊乱全部为低Na^＋或低Na^＋＋低Cl^-,而应用利尿剂的病人电解质紊乱表现多样。结论随心力衰竭程度的加重,老年CHF病人电解质紊乱的发生率增加,且以低Na^＋、低Na^＋＋低Cl^-为主,尤其是未用利尿剂病人。

CLINICAL FEATURES OF ELDERLY PATIENTS WITH CORONARY HEART DISEASE IN ASSOCIATION WITH CHRONIC HEART FAILURE AND ELECTROLYTE DISTURBANCES

Objective To investigate clinical features of elderly patients with coronary heart disease in association with chronic cardiac failure and electrolyte disturbances. Methods Clinical data of 102 patients with above-mentioned problems treated in July 2004-March 2007 were reviewed retrospectively. Results With the aggravation of chronic cardiac failure, the incidence of electrolyte disturbances in the patients increased,the levels of serum Na＋ and CI^- in patients with grade 4 heart function on admission were lower than normal value, but serum K^＋ level in patients with different grade showed no statistically significant difference. In patients with electrolyte disturbances, the incidence of low serum Na^＋ and low both serum Na^＋ and CI was significantly higher than low serum K^＋ and low both K^＋ and CI . Simultaneous low serum K^＋ , Na^＋ and Cl^- seen only in those with heart function of grades 3 and 4. On electrolyte disturbances, for those who were not given diuretic showed low serum Na^＋ or low both Na^＋ and CI ; for those who had taken diuretic showed variform. Conclusion With the aggravation of heart failure, the incidence of electrolyte disturbances increased in senior patients, main findings being low Na^＋ and low both Na^＋ and Cl^- , especially for those who did not take diuretic.