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目的:分析心力衰竭住院死亡病例的病因变化、临床特点、死亡方式、死亡时间,为心力衰竭的防治提供依据。方法:采用回顾性病史分析方法,根据死亡病例病因及治疗的变化,分为2个时段进行比较分析。结果:①死亡病例的病因以冠心病和风湿性心脏瓣膜病为主,分别为52.0%和28.3%;随时段的发展,风湿性心脏瓣膜病的比例明显下降(36.2%∶20.3%,P<0.01),冠心病的比例显著增加(43.4%∶60.8%,P<0.01),主要是由于心肌梗死后心力衰竭的增加(15.8%∶32.4%,P<0.01);②死亡年龄趋于向高龄化发展,并发原发性高血压、糖尿病、陈旧性心肌梗死的比例随时段明显增加(P<0.05或0.01),分别为28.3%∶39.2%、10.5%∶23.6%、17.1%∶31.8%、13.8%∶30.4%;③住院期间药物应用以利尿剂、洋地黄类和硝酸酯类为主,总体应用比例分别为83.3%、81.7%、85.0%,ACEI和β受体阻滞剂使用上升,分别由时段1的44.1%、5.9%升至时段2的60.1%和12.8%;④死亡方式依次为,泵衰竭死亡131例(43.7%),猝死88例(29.3%),其他并发症死亡81例(27.0%);⑤死亡月份有统计学意义,集中于1月份。结论:心力衰竭住院死亡病例的病因以冠心病和风湿性心脏瓣膜病为主,随时段的发展,冠心病的比例明显上升,主要是心肌梗死后心力衰竭的增加;泵衰竭和猝死是心力衰竭的主要死亡方式;心
Objective: To analyze the etiological changes, clinical features, methods of death and time of death in hospitalized death cases of heart failure, and provide the basis for the prevention and treatment of heart failure. Methods: A retrospective analysis of medical history, according to the cause of death and treatment changes, divided into two periods for comparative analysis. Results: ① The causes of death were mainly coronary heart disease and rheumatic heart valvular disease, which were 52.0% and 28.3% respectively. The incidence of rheumatic heart valvular disease was significantly decreased over time (36.2%: 20.3%, P < 0.01). The proportion of coronary heart disease increased significantly (43.4% vs 60.8%, P <0.01), mainly due to the increase of heart failure after myocardial infarction (15.8% vs 32.4%, P <0.01) The proportions of essential hypertension, diabetes mellitus and old myocardial infarction were significantly increased with time (P <0.05 or 0.01), which were 28.3%, 39.2%, 10.5%, 23.6%, 17.1% and 31.8% 13.8%: 30.4%; ③Drugs, digitalis and nitrates were the main drugs during hospitalization. The overall application rates were 83.3%, 81.7% and 85.0% respectively. The use of ACEI and β-blockers increased, Respectively, increased from 44.1% and 5.9% in period 1 to 60.1% and 12.8% in period 2 respectively. ④ The death modes were: 131 cases (43.7%) died of pump failure, 88 cases (29.3%) died of sudden death and 81 Cases (27.0%); ⑤ death month was statistically significant, concentrated in January. Conclusions: The causes of death from heart failure in hospitalized patients are mainly coronary heart disease and rheumatic valvular heart disease. With the development of time period, the proportion of coronary heart disease increased significantly, mainly due to the increase of heart failure after myocardial infarction. Pump failure and sudden death were heart failure The main way of death; heart