老年高血压合并心衰的危险因素分析(1)
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【摘要】 目的 探讨老年高血压合并心力衰竭的危险因素，为减少心衰发生，减少致残率、致死率提供依据。方法 回顾性调查老年高血压病患者235例，对100例合并心衰者(观察组)与135例未合并心衰者(对照组)进行Logistic回归分析。结果 多因素Logistic逐步回归分析显示：血压达标，合并感染，合并高尿酸血症，左室肥厚，吸烟对高血压合并心衰的影响有显著意义(P<0.05)。结论 积极控制老年高血压，增加血压达标率，控制左室肥厚，同时控制高血脂高尿酸血症等危险因素对减少老年高血压病患者心衰的发生减少致残率、致死率有积极意义。
【关键词】心力衰竭；老年；高血压；危险因素
Risk factors analysis of hypertension with heart failure in geriatric age patients
ZHAO Jian-ping,LUO Zhi,FAN Yan-qin,et al.Department of Cardiology,Beijing elderly hospital,Beijing 100095,China
【Abstract】 Objective To explore the risk factors of hypertension with heart failure in the elderly and to provide the basis in reducing disability and mortality in patients of old age. Methods We retrospectively investigated 235 older adults with hypertension.The patients were divided into two groups based on different situations:100 patients of hypertension with heart failure(observation group)135 patients of hypertension without heart failure(comparative group)Logistic regression analysis was done on these two groups of patients. Results Multi-factor Logistic regression analysis has shown that many factors are of great significance in the patients of hypertension with heart failure.(P<0.05)These contributory factors are as follows:the reaching standard rate of blood pressure, the combination of hypertension with infections/hyperlipidaemia/hyperuricaemia, hypertrophy of left ventricular, smoking.Conclusion Our conclusion is that some therapeutic methods are of great importance in lowering the incidence of the heart failure in old patients of hypertension as well as reducing disability and mortality.These methods are as follows:Actively controlling blood pressure in the very elderly, enhancing the reaching standard rate of blood pressure, curbing the risk factors such as LVH(left ventricular hypertrophy), hyperlipidaemia and hyperuricaemia.
【Key words】 Heart failure; Geriatric; Hypertension; Risk factors
心力衰竭(心衰)是一种复杂的临床症候群，是各种心脏病的严重阶段，具有很高的致残率和病死率。高血压作为导致心衰的一种主要的心血管疾病也备受重视。在美国，高血压是心力衰竭的主要病因，FHS报道的5123例充血性心力衰竭病例中，91%在发生心衰前有高血压，357例高血压和并心衰患者的平均生存时间男为1.37年，女为2.50年。5年存活率男性为24%，女性为31%。本研究的目的是分析老年高血压病患者合并心力衰竭的危险因素，旨在减少老年高血压心衰的发生率，最终提高老年高血压病患者的生存率和生活质量。
1 资料与方法
1.1 病例及对照选择 2007年9月至2009年12月我院住院诊治的老年高血压病患者235例，年龄60~95(77.5±9.4)岁，合并心衰者100例，其中男 62例,女38例。其余为非合并心衰组，其中男91例，女44例。
1.2 调查方法及内容 回顾性调查入选病例，病历记录，设立统一调查表，内容包括与心衰有关的因素13项，分别为：性别、年龄、血压达标、合并感染、合并高脂血症、合并糖尿病、合并高尿酸血症、肾功不全、左室肥厚、长期卧床、吸烟、房颤、高血压病史时间等。
1.3 统计学方法 Excel录入数据 ......
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