射血分数正常性心力衰竭的预后研究——附三年随访结果分析

目的：评价射血分数（EF）正常性心力衰竭患者的流行病学特点及其3年预后,并与EF降低性心力衰竭患者进行比较。方法：选择2005-1至2006-12二所三甲医院心内科收治的461例慢性心衰患者,根据入院时左室EF分为EF正常组（EF〉=50%）和EF降低组（EF〈50%）,进行为期3年的电话随访;终点事件包括全因死亡、心衰加重再住院。结果：慢性心衰患者中EF正常234例（50.7%）,与EF下降患者比较,这类患者中较为高龄、多为女性;病因多为瓣膜病、高血压病及房颤;随访结果显示二组患者的终点事件发生率并无明显差异（P=0.578）,Cox回归分析对其它因素校正后发现,房颤（RR=1.301,95%CI：0.995-1.701,P〈0.05）、年龄（RR=1.012,95%CI：1.003-1.022,P〈0.05）是影响慢性心衰患者3年预后的主要因素。结论：在慢性心衰中,EF正常的患者预后与EF下降者相似,对这类病人同样应加强监测及治疗。

Research of Prognosis of Chronic Heart Failure with Preserved Ejection Fraction

Objective： To evaluate the epidemiologic features and prognosis of patients with chronic heart failure（CHF） with pre-served ejection fraction（EF） and to compare with the patients who had CHF with reduced EF.Methods： From January,2005 to Decem-ber,2006 we studied 461 patients with a discharge diagnosis of CHF.Patients were devided by baseline EF in preserved EF（EF=50%） and reduced EF（EF50%） group.The main endpoints were all cause death within 3 years and readmission to the hospital for heart failure.Results： Two hundreds and thirty four patients（50.7%） had an EF of more than 50%.During 3 year follow-up,the main endpoints was similar in two groups（P=0.578）;After adjusting for other covariables,AF and advanced age were related to increased the risk of main endpoints during 3 years follow-up（RR=1.301,95%CI： 0.995-1.701,P0.05;RR=1.012,95%CI： 1.003-1.022,P0.05）.Conclusions： The prognosis of patients with CHF with preserved EF was similar to that of patients with reduced EF.Therapy and monitor should be proven in these patients.