【摘要】 目的:探讨急性心力衰竭患者的性别差异的临床意义。方法:选择2007年8月—2012年12月广东省江门市人民医院重症医学科(intensive care unit,ICU)与心内科收治的因各种心脏病所致的急性心力衰竭患者96例,其中男性60例,女性36例,分析其临床资料。结果:发生急性心力衰竭存在性别差异。女性患者平均年龄稍大,肥胖者较多,但与男性患者相比差异无统计学意义。男性患者吸烟比例[66.7%(40/60)],高于女性患者[0.0%(0/36)](P<0.05)。女性患者病因以高血压心脏病为主,主要表现为舒张期功能障碍[44.4%(16/26)比26.7%(16/60)],男性患者病因以冠心病为主,主要表现为收缩期功能障碍[53.3%(32/60)比27.8%(10/36)],P<0.05。女性患者心电图(electrocardiogram,ECG)表现为左心室大的比例高于男性患者[83.3%(30/36)比56.7%(34/60)],心房颤动比例低于男性[33.3%(12/36)比53.3%(32/60)];胸部X线片示肺水肿比例低于男性患者[50.0%(18/36)比66.7%(40/60)];心脏B超示左心室射血分数(left ventricular ejectionfraction,LVEF)<40%比例少于男性患者[72.2%(26/36)比93.3%(56/60)];B型-N端脑钠肽(N-terminal pro-B-type natri-uretic peptide,NT-proBNP)水平低于男性患者[(1 801.0±256.6)pg/mL比(2 150.0±318.3)pg/mL],差异均有统计学意义(P均<0.05)。女性患者合并糖尿病的比例高于男性患者[55.6%(20/36)比40.0%(24/60)],而合并肾功能不全的比例低于男性患者[11.1%(4/36)比23.3%(14/60)],差异均有统计学意义(P均<0.05)。女性患者住院病死率低于男性患者[11.1%(4/36)比20.0%(12/60)],差异有统计学意义(P<0.05)。结论:女性急性心力衰竭病因以高血压心脏病为主,主要表现为舒张期功能障碍;而男性以冠心病为主,主要表现为收缩期功能障碍。女性急性心力衰竭患者预后较男性患者好。更多还原

【Abstract】 Objective:To investigate the clinical significance of gender differences in acute heart failure.Methods:From Aug 2007 to Dec 2012,a total of 96 patients with acute heart failure due to variant heart diseases were treated in intensive care unit(ICU) and Department of Cardiology of Jiangmen People′s Hospital.Among them,there were 36 females and 60 males.Results: There were gender differences in patients with acute heart failure.Older age,obesity were more common in female patients compared with male patients,but there were no significant differences.The proportion of smoking in male patients 66.7 %(40/60) was higher than that in female patients 0.0 %(0/36)(P<0.05).Hypertensive heart disease was main etiology,and the diastolic dysfunction was the main characteristic in female patients 44.4 %(16/26) vs.26.7 %(16/60),the coronary heart disease was the main etiology and systolic dysfunction was the main characteristic in male patients53.3 %(32/60) vs 27.8 %(10/36),P<0.05.Electrocardiogram(ECG) showed that 83.3 %(30/36) had left ventricular enlargement and 33.3 %(12/36) had atrial fibrillation in female patients,while those were 56.7 %(34/60) and 53.3 %(32/60) in male patients.Chest X-ray film showed that 50.0 %(18/36)had pneumonedema in female patients,which was lower that in male patients66.7 %(40/60).Cardiac ultrasound showed that 72.2 %(26/36) had left ventricular ejection fraction(LVEF)<40 % in female patients,which was lower than that in male patients93.3 %(56/60).N-terminal pro-B-type natriuretic peptide(NT-proBNP) was(1 801.0±256.6)pg/mL in female patients,which was lower than that in male patients(2150.0±318.3)pg/mL,showing significant differences(P all<0.05).There were 55.6 %(20/36)and 11.1 %(4/36) female patients with combined diabetic mellitus and renal insufficiency,which were 40.0 %(24/60),23.3 %(14/60) in male patients;showing significant differences(P all<0.05).Hospital mortality in female patients was lower than that in male patients 11.1 %(4/36)vs.20.0 %(12/60),showing significant difference(P<0.05).Conclusions: The main etiology of acute heart failure was hypertensive heart disease and the main characteristic is diastolic dysfunction in female patients.Whereas,the main etiology was coronary heart disease and the main characteristic was systolic dysfunction in male patients.Prognosis of female patients with acute heart failure is better than that of male patients.更多还原