【摘要】 目的:了解慢性心力衰竭(心衰)患者临床变迁,为该病防治策略提供依据。方法:将单中心20年连续住院的心衰患者分两个时段比较,分析病因、治疗变化和死亡方式。结果:①共入选3 260例患者,第一时段即1984年-1993年1205例,第二时段即1994-2003年2055例,第二时段患者年龄显著增加(54．27±15．21 vs 66．23±13．73,P<0．01),风湿性心脏瓣膜病心衰明显下降(47．8％vs 21．4％,P< 0．01),冠心病显著增加(31．4％vs 64．1％,JP<0．01);②合并高血压、糖尿病的比例第二时段显著增加(17．8％vs 35．6％,P<0．01;8．9％vs 14．0％,P<0．05);③硝酸酯(77．8％vs 85．5％,P<0．001)、血管紧张素转换酶抑制剂(55．3％vs 65．2％,P<0.001)和β受体阻滞剂(18．4％vs 23．2％,P<0．05)使用率第二时段明显上升;④心衰患者死亡冬季多。结论:过去的20年间,住院慢性心衰患者临床特征发生了明显变化,临床防治策略应做出相应改变。更多还原

【Abstract】 Objective:To provide scientific basis for prevention and treatment of chronic heart failure(CHF). Methods: A comparative study was performed to analyze the major causes, drug administrations, modes of death and death time of consecutive inpatients with CHF from a single center during 20 years. Results:①3260 CHF patients were enrolled in this study. 1205 patients were hospitalized from 1984 to 1993 and 2055 from 1994 to 2003. The occurrence of rheumatic heart diseases was decreased(47.8% vs 21. 4%,P <0.01) and coronary heart diseases was significantly increased(31.4% vs 64. 1% ,P<0. 01). The years of age were increased in the patients of the second population(54. 27±15. 21 vs66.23±13.73,P <0.01).②The incidence of hypertension,diabetes mellitus was significantly increased over time(17. 8% vs 35. 6% ,P <0. 01 ;8. 9% vs 14. 0% ,P <0. 05,respectively).③During hospitalization,the frequency of the administrations of nitride, ACEI,β-blocker were increased in the second study(77. 8% vs 85. 5% ,P <0. 001; 55. 3% vs 65. 2% ,P <0. 001 ;18. 4% vs 23. 2% ,P <0. 05 .respectively).④Most mortality occurred in January. Conclusions:The clinical characteristics have significant changes in the inpatients with chronic heart failure during the past 20 years.更多还原