| Objective To investigate the charactistics, etiology, medication, outcome of hospitalized patients with chronic heart failure during the past 30 years in our hospital. To detect the changes about the etiology and treatment of heart failure from 30 years ago to now, and provide more information on the diagnosis, prevention and treatment strategy of heart failure. Methods All data was taken from the hospitalized cases with chronic heart failure from 1973. 7to 2002.7. Results 2025 cases were enrolled and the number of times were altogether 3031. The male and female were half and half and the average age was (61. 17?14. 73) years. The average age of males were older than females' and were (62.46 ?14. 41) years and (59. 88 + 14. 92) years respectively. The age was to aged . 61. 5% were older than 60 years and 6. 1% were older than 80 years. Common causes were rheumatic heart disease, coronary heart disease, hypertensive heart disease, dialated cardiomyopathy and congenital heart disease. The first cause of chronic heart failure has changed from rheumatic valve heart disease to coronary heart disease. From 70, 80 to 90 decade the proportion of coronary heart disease in patients with chronic heart failure was 24. 1%, 31. 4% and 64. 1% (PO.001) . Meanwhile rheumatic heart disease declined from the first cause of heart failure in the past to the second now and the proportion of was 61. 3%, 47.8% and 21. 4% from 70 , 80 and 90 decade C/><0.001) . The distribution of cause was chracteristic of gender and age. The females were prone to rheumatic and hyperthyroid heart diseases and the males were coronary heart disease, dialated and hypertrophic cardiomypathy. The patients The majority over 65 years was coronary heart disease (81. 9%) and only 23. 4% under 65 years (P<0.001) .The most patients' heart functions before hospitalization were NYHA III and IV (85. 1%) and the same in the three fixed number of years. The diuretics, digitalis and nitride still dominated the drug therapyin hospitalized patients with heart failure, with the total proportion of 77.2%, 77.6% and 81. 1% respectively. The users of ACEI, 3 -blocker, a + P -blocker and angiotensin receptor blocker increased year after year. The proportion of patients receiving ACEI and P -blocker raised from 41.9%, 12.5% during 70 decade to 23.2%, 65.2% during 90 decade respectively (P<0.001) . Sodium nitroprusside has special advantage in controlling heart failure and its user also increased from past to now. The heart failure was corrected during hospitalization, and the hospitalized improvement rate was 75.3%, 82.5% and 86.7% during 70, 80 and 90 decades respectively (PO.001 ) with decreased hospitalized morbidity rate being 16.0%, 11.2% and 6.4% (PO.001 ) . The total hospitalized improvement and hospitalized morbidity rate were 84. 4% and 8.6% respectively. The death causes of hospitalized heart failure were in turn pump failure (42.7%), complications of cerebral embolism and respiratory failure (26.3%), sudden death (14.1%), arrhythmia (12.6%) and cardiogenic shock (4.3%). The major hazard factors correlated to hospitalized morbidity rate of heart failure were heart function NYHA IV before hospitalization and hypertension. Conclusions The primary diseases causing chronic heart failure in the hospitalized patients shifted from rheumatic heart disease to the coronary heart disease during the past 30 years. The conventional drugs still dominate the majority therapy for the heart failure, but the users of ACEI and 3 -blocker increased significantly. The major hazard factors correlated to hospitalized morbidity rate of heart failure were heart function before hospitalization and hypertension. |
PDF Full Text Request