| Objective：To analysis clinical data of the chronic heart failure hospitalized patients with reducedleft ventricular ejection fraction, to detect the clinical characteristics and drug treatment statusabout the chronic heart failure patients with reduced left ventricular ejection fraction and toprovide more reference on optimizing treatment strategy of chronic heart failure patients withreduced left ventricular ejection fraction.Methods:By adopting the method of retrospective case analysis, using the medical record querysystem, all cases were investigated and analysed in the First Hospital of Jilin University, onFebruary1,2014-November31,2014Cardiovascular Center of the First Hospital of JilinUniversity, to query the697cases’ medical records of the chronic heart failure hospitalizedpatients with reduced left ventricular ejection fraction and set up the database, including thegeneral situation, smoking history, etiology, factors, heart function grading, merger otherdiseases, biochemical examination, electrocardiogram, echocardiograhpic and drug usage, etc.It is divided into four levels, including Ⅰ, Ⅱ, Ⅲ, Ⅳ, according to the NYHA heart functionclassification, at the same time, it is divided into six age groups,<40years old,40~49years old,50~59years old,60~69years old,70~79years old,≥80years old, according to the age.Application of SPSS22.0statistical software package, there are standard statisticalcomparison analysis according to the above group.Results:(1) There are697hospitalized patients of chronic heart failure with reduced leftventricular ejection fraction, which accounted for7.05%of all patients in cardiovascularcenter of the First Hospital of Jilin University at the same period. The genders about65.3%ismale (male more than female, P<0.05), the average age is (61.48±13.38) years old, the average age of women (64.74±12.28) years old is significantly higher than the average age ofman (59.74±14.09) years old, P<0.05); The age range of patients from50to79years oldaccounted for74.2%, and most of their NYHA heart function classification was Ⅲ orⅣwhen they were admitted to hospital, which accounted for87.8%; Therefore, it has nostatistical significance in different gender, different age of patients with cardiac functionclassification comparison difference (P>0.05).(2) The697patients of etiological distribution for340cases of coronary heart disease(48.8%),192cases of dilated cardiomyopathy (27.5%),83cases of cardiomyopathy (11.9%),38cases of hypertensive heart disease (5.5%),13case of noncompaction of ventricularmyocardium (1.9%),11cases of cor pulmonale (1.6%),8cases of nonrheumatic heart valvedisease (1.1%),3cases of rheumatic heart valve disease (0.4%),9cases of others (1.3%). Theproportion of female with cor pulmonale and coronary heart disease is higher than the malewhile the proportion of male with dilated cardiomyopathy is higher than the female; Thenumber of having significant incentives lead to attack accounted for33.7%, and the incentivescontain177cases (75.3%) with the respiratory system infection,37cases (15.7%) withfatigue,5cases (2.1%) with drug withdrawal,4cases (1.7%) with emotion,3cases (1.3%)with the digestive system infections,9cases (3.8%) with other incentives.(3) In these697patients, with chronic cardiac insufficiency that have many risk factors.They composed of401cases (57.5%) with hypertension,304cases (43.6%) with smoking,296cases (42.5%) with diabetes,228cases (32.7%) with coronary artery disease,227cases(32.6%) with hyperlipidemia,137cases (19.7%) with high uric acid hematic disease. The452cases (64.8%) have arrhythmia that is mainly complication,199cases (28.6%) withhyponatremia,141cases (20.2%) with renal insufficiency,95cases (13.7%) with thyroiddisease,75cases (10.8%) with cerebral infarction,73cases (10.5%) with anemia,65cases(9.3%) chronic obstructive pulmonary disease,63cases (9.0%) thrombotic diseases. Mergerof arrhythmia patients, give priorities to ventricular premature (246/35.3%), atrial fibrillation(150/21.5%), atrial premature (134/19.2%), and ventricular tachycardia (104/14.9%). Thepriority of patients have two or more than two kinds of arrhythmia.(4) The treatment of drugs for697patients is diuretic,666cases (95.6%); spironolactone,642cases (92.1%); βreceptors blockers,549cases (78.8%); digitalis,536cases (76.9%); nitrate,509cases (73.0%); ACE,408cases (58.5%); ARB,119cases (17.1%); milrinone,71cases (10.2%); levosimendan,26cases (3.7%); Lyophilized Recombinant Human BrainNatriuretic Peptide,18cases (2.6%); tolvaptan,9cases (1.3%). The New York HeartAssociation of classification Ⅱis used to apply for ACEI and βreceptors blockers, with thedeterioration of cardiac function, usage gradually reduce. The New York Heart Association ofclassification Ⅲ is used to apply for ARB and spironolactone. Cardiac function Ⅳlevel canhave different degree of reduced.Conclusions:(1) The total hospitalization rate of the chronic heart failure hospitalized patients withreduced left ventricular ejection fraction is7.05%, mainly includes the middle-aged andelderly, whose heart function were mostly in III、IV level. From the perspective of gender,male is more than female.(2) The mainly causes of the chronic heart failure hospitalized patients with reduced leftventricular ejection fraction are coronary heart disease, dilated cardiomyopathy andhypertensive heart disease; The induction factors are respiratory infections, overworked, drugwithdrawal and so on.(3) The major hazard factors of the chronic heart failure hospitalized patients withreduced left ventricular ejection fraction are hypertension, smoking, diabetes, coronary arterydisease, hyperlipidemia, etc; The common accompanying diseases are arrhythmia, hyponat-remia and renal insufficiency.(4) The drug treatment of the chronic heart failure hospitalized patients with reduced leftventricular ejection fraction is more effectively utilization in diuretics, aldactone, digitalis,nitrates than β-blocker, ACEI and ARB, where there is a certain gap between usage and heartfailure treatment guidelines in the latter several drugs, therefore, there is a long way to extendnewtype drugs’ application. |
PDF Full Text Request