| Object:To investigate the tendency of general state of health, length of hospitalization, etiology, cause, methods of diagnosis,drug therapy and prognosis of hospitalized patients with chronic heart failure during the past 10 years in Zhongshan hospital.Methods:All data was taken from the hospitalized cases with chronic heart failure in Zhongshan hospital.The patients of group A were admitted in hospital during Jul 1,1998 to Jul 1,1999;and the patients of group B were admitted in hospital during Jul 1,2008 to Jul 1,2009.Results:1.Among the selected 610 patients,347 cases of male and 263 cases of female, the mean age of which are 58.2±14.6(male)and 64.7±19.1(female). The length of hospitalization of group B(11.5+8.4 days)is significantly shorter than that of group A(21.2±15).(P<0.001).And the annual readmission rate of group B(4.7%) is significantly lower than that of group A(14.74%).(P<0.001).2.The changes in heart failure etiology are significant:the proportion of rheumatic valve disease dropped from the 28.85% to 13.42%, while that of coronary heart disease increased from 23.72% to 39.93% (P<0.001).The cause of acute episode also changed:the proportion of infection dropped from 51.28% to 34.55% (P<0.001),while that of ACS increased from the 11.53% to 30.2%(P<0.001).3.The application rate of Chest radiography and echocardiography have significantly increased (27.88%:73.83%, P<0.01;17.63%:76.51%,P<0.01). The positive rate of echocardiography also improved significantly (67.27%:87.72%,P<0.01).The application rate and positive rate of NT-proBNP are 94.3% and 92.88%.4. Levels of white blood cell count (WBC) and red blood cell distribution width (RDW) are associated with the severity of CHF.5.The Medications during hospitalization of group A:Diuretics 78.52%, aldosterone receptor antagonist 70,83%, digitalis 29.81%,non digitalis inotropic drugs 38.2%,nitrate 75.64%,β-locker 14.1%,ACEI 44.55%,ARB 0%,calcium antagonists 36.86%;group B:diuretics 93.62%, aldosterone receptor antagonist 86.58%,digitalis 34.9%, non-digitalis positive inotropic drugs 34.9%, nitrate 85.23%, calcium antagonists 33.22%,β-locker 74.16%, ACEI 66.11%, ARB 17.2%. The application rate ofβ-blocker, ACEI and ARB significantly increased.sinus bradycardia is the main reason whyβ-blocker is dropped, and the reason that for ACEI dues to low blood pressure.6. There is no significant difference between the prognosis of patients whose heart function are NYHAⅡ.However, the progression rate(4.85%: 1.61%) and mortality (6.33%:2.69%) of patients, heart function of whom are NYHA III-NYHA IV, are significantly decreased during hospitalization.Conclusion:The major cause for hospitalized patients with chronic heart failure has shifted from rheumatic valve disease to coronary heart disease during the past ten years.Although infection is still the main cause of acute episode, the proportion of ACS is significantly increased. NT-proBNP plays an important part as a marker for heart failure diagnosis, there is a certain correlation between WBC and RDW levels with the severity of CHF. Drug treatment of heart failure based on traditional medicines, while the use ofβ-locker, ACEI and ARB has been significantly increased. The level of Standardized drug treatment is significantly increased;the prognosis of hospitalized patients is obviously improved. |
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