摘要目的 了解湖北地区慢性心力衰竭(心衰)患者年龄和病因分布特点及心衰治疗情况.方法 回顾性调查和分析湖北地区8地市12家三级甲等医院2000年至2010年心衰住院患者资料.结果 共12 450例患者入选,其中男性7166例(57.56%),年龄(62.0±14.5)岁.心衰住院患者年龄有减低趋势(P<0.01).心衰最常见病因为:高血压(31.54%)、冠心病(28.24%)、扩张型心肌病(26.57%)、风湿性心脏病(17.49%).不同年龄分组病因分布不同(P<0.01).治疗以洋地黄类、利尿剂、血管紧张素转换酶抑制剂类、β受体阻滞剂和醛固酮受体拮抗剂为主,分别占47.49%、68.75%、50.66%、44.06%和53.08%.但β受体阻滞剂随纽约心脏功能分级增加而使用量减少.结论 湖北地区心衰住院患者年龄有减低趋势.病因以高血压最常见,不同年龄组患者病因分布不同.心衰治疗与规范化治疗尚有差距.

abstractsObjective To evaluate the current status of chronic heart failure (CHF) in Hubei province and analyze the epidemiology of CHF including the general condition, etiology and pharmacological therapy.Methods Data of in-hospital patients with CHF were investigated between 2000 and 2010 from 12 hospitals in Hubei Province. Inclusion criteria: over 18 years of age, organic heart disease and with the symptom of HF including dyspnea and fatigue. Patients with a history of myocardial infarction in the prior 12 months,congenital heart disease, pericardial disease and the history of cancer were excluded. Results (1) A total of 12 450 patients were enrolled (7166 male, 57.56%). The average age was (62.0±14.5) years. Patients in the scale of age ≥80, 70-79, 60-69, 50-59, 40-49 and ＜40 was 9.53%(1187/12 450), 30.80% (3835/12 450), 23.45% (2920/12 450), 18.81% (2342/12 450), 10.73% (1336/12 450) and 6.67% (830/12 450), respectively (P<0.01). The NYHA class Ⅰ,Ⅱ,Ⅲ and Ⅳ was 0.60%, 23.20%, 50.31% and 26.50%, respectively. (2) The age of patients was significant reduced from 2000-2003, 2004-2006 to 2007-2010 [(66.4±14.1) years, (64.9±14.4) years and (64.2±14.8) years, P<0.01]. (3) The major causes of CHF were hypertension (31.54%), coronary heart disease (28.24%), dilated cardiomyopathy (26.57%) and rheumatic valvular heart disease (17.49%). The most frequent etiology for CHF was rheumatic valvular heart disease in patients aged less than 40 years old, dilated cardiomyopathy in patients aged 40-49 and 50-59 years and hypertension in patients aged 60-69, 70-79 and ≥80 years. (4) Drug use was as follows: Digitalis (47.49%), diuretics (68.75%), ACEI (50.66%),β-blocker (44.06%) and aldosterone antagonist (53.08%). Use of digitalis (Wald χ2=903.41, P<0.01;r=0.271,P<0.01), diuretics (Wald χ2=818.05, P<0.01;r=0.249, P<0.01), aldosterone antagonists (Wald χ2=76.92, P<0.01;r=0.091, P<0.01) increased while the β-blocker (Wald χ2=160.65, P<0.01;r=-0.117,P<0.01) declined in proportion to NYHA class increase.Conclusions The age of in-hospital patients with CHF declined in the previous 10 years. The primary etiology was hypertension for aged CHF in-hospital patients with CHF. There was big gap between guideline recommended standard therapy and current drug use for in-hospital patients with CHF in Hubei province.