| Objective:To retrospectively analyze the clinical features,diagnosis and treatment of chronic heart failure(CHF)inpatients in XXX Hospital from 2012 to 2016.Methods: The CHF patients who were admitted to the General Hospital of XXX from2012.1.1 to 2016.12.31 were selected according to the Chinese CHF guidelines for diagnosis in 2014,and NYHA class I-IV CHF patients(988 patients)were selected.Collect general information,cause of illness,comorbidity,auxiliary examination,and drug use of patients who meet the criteria.According to the cases screened in the case file,we entered the electronic case system of our hospital to search for information,enter it,and set up a database.Retrospective analysis was used to analyze cases as a whole and year by year.Result:(1)The proportion of etiological factors of CHF patients from high to low in recent 5years were as follows: coronary heart disease 55.70%,dilated heart disease 24.10%,valvular heart disease 9.80%,hypertension 6.60%,congenital heart disease 2.50%,hypertrophic cardiomyopathy 0.50% Hyperthyroidism was 0.40%,and perinatal cardiomyopathy was0.40%.(2)Drug therapy for CHF patients in the past 5 years: diuretics 96.10%;ACEI/ARB 84.10%,beta blockers 85.20%;aldosterone receptor antagonists(spirolactone)94.00%;gold triangle drugs combined 69.94%.(3)The reason why ACEI/ARB was not used in patients with CHF in the past 5 years was as follows: The proportion of 15.6% was not used,of which 3.54% was hypotension,and 4.86%was abnormal renal function.The cause was unclear 7.49%.(4)?-blockers were not used in patients with CHF in the past 5 years.Reasons: Unemployed rate of 14.78%,central bradycardia(heart rate <55 beats/min)0.70%,secondary atrioventricular block 1.00%,Heart rate(55-60 beats / min)1.00%,other reasons 12.08%.(5)Aldosterone receptor antagonist(spirolactone)doses and non-use reasons for CHF patients in the past 5 years: The use ratio was 94%,of which 20mg/day was 88.3%,and10mg/day was 2.6%,20 mg / 0.9% for 2 times daily,0.7% for 40mg/ twice daily;6.0% for unused dose,4.86% for abnormal renal function,unexplained 1.11%.(6)There was significant difference between the two groups in HGB,PLT,P-LCR,and SD(p<0.05)in dilated cardiomyopathy with mural thrombosis group and non-combined thrombosis group;both groups were in BNP,ALT There was no significant difference between LVEF,LVED and LVFS(p>0.05).(7)Logistic regression analysis of left ventricular mural thrombus formation in dilated cardiomyopathy showed that HGB,P-LCR,and SD were all p<0.05,indicating statistical significance.Conclusion:(1)Coronary heart disease is the main cause of CHF in the past 5 years.(2)The combined use of the Golden Triangle drugs is good and meets the guidelines.(3)ACEI/ARB is not used because: Hypotension,abnormal kidney function,and unexplained causes.(4)?-blockers were not used for reasons: second-degree or more atrioventricular block,heart rate compliance was not used(55-60 beats/min),bradycardia(heart rate <55 beats/min),and the cause was unknown.(5)The use of aldosterone receptor antagonist(spironolactone)at a dose of 20 mg/day is basically in accordance with the guidelines and is not used because of abnormal kidney function and unclear causes.(6)HGB,P-LCR,and SD were independent risk factors for the formation of mural thrombus in dilated heart disease. |
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