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心力衰竭是心脏病发展的终末阶段 ,发病率高 ,总体预后很差 ,对心力衰竭预后的随机临床研究显示 ,NYHAⅠⅡ级患者的年死亡率在 5%左右 ,而NYHAⅢⅣ级的重症患者 6个月的死亡率高达 3 7% ;非随机临床观察显示心力衰竭患者的年死亡率为17.1% ;而在大规模人群研究中死亡率更高 ,Framingham研究中心力衰竭的平均年死亡率为 2 1%。对心力衰竭死亡率的影响因素有很多 ,其中年龄增高、左室射血分数降低、NYHA分级高、血浆BNP水平升高、体重指数明显减低和合并糖尿病、肾功能减低的患者预后不良 ,对不同病因的患者 ,冠心病心力衰竭患者的预后较其他病因患者差 ,性别和伴发房颤对心力衰竭的预后在不同研究中结论不一致 ,此外 ,治疗方法对心力衰竭的预后也有很大影响 ,应用ACEI和β阻制剂及ICD植入等非药物治疗可明显改善预后。
Heart failure is the terminal stage of the development of heart disease, the incidence is high, the overall prognosis is poor, randomized clinical studies on the prognosis of heart failure, NYHA Ⅰ Ⅱ-year mortality in patients with about 5%, while NYHAⅢⅣ-level severe patients 6 The monthly mortality rate was as high as 37%. The non-randomized clinical observation showed that the annual mortality rate of heart failure patients was 17.1%. In the large-scale population study, the mortality rate was higher. The average annual mortality rate of framingham research center failure was 21 %. There are many factors affecting the mortality rate of heart failure, including age, decreased left ventricular ejection fraction, NYHA high grade, elevated plasma BNP levels, body mass index was significantly lower and with diabetes, renal dysfunction in patients with poor prognosis, different Patients with etiology, heart failure patients with coronary heart disease prognosis worse than other patients, gender and associated with atrial fibrillation on the prognosis of heart failure in different studies concluded inconsistent, in addition, the treatment of heart failure prognosis have a great impact, the application Non-drug therapy such as ACEI and β-blocker and ICD implantation can significantly improve the prognosis.