年龄与老年高血压并发心力衰竭患者发生多器官功能衰竭的关系

目的:分析年龄对老年高血压患者伴发心力衰竭(CHF)后诱发多器官功能衰竭(MODSE)的关系,探讨年龄和CHF对老年高血压患者发生MODSE的预测值。方法:回顾性分析≥60岁高血压患者的19996例病历资料(男性13229例,女性6767例,平均年龄74.21±7.52),以10岁为界60~69岁、70~79岁、80~89岁和≥90岁划分年龄段,以69、79和89岁为分界点,分别分析各年龄段及各分界年龄上下老年高血压患者中因CHF并发MODSE的发生率。结果:①所有CHF患者中MODSE的发生率较非CHF患者升高(7.43%vs3.05%,χ2195.15,说明CHF是影响老年高血压患者出现MODSE的重要影响因素;②60~69岁、70~79,80~89岁和≥90岁发生CHF的比例分别10.60%vs18.88%vs30.11%vs60.57%,P<0.05,差异有统计学意义。4个年龄段发生MODSE分别为1.68%vs7.06%vs17.08%vs25.47%,P<0.05,有统计学差异。高血压患者中CHF的发生率与CHF中MODSE的发生率呈正相关r=0.696(P<0.01);年龄与老年高血压患者并发CHF的发生率以及年龄与CHF中MODSE发生率亦呈正相关r=0.987(P<0.01)。排除年龄因素的影响对CHF与MODSE的发生率进行偏相关分析表明r=-0.776(P>0.05),说明年龄是老年高血压患者并发CHF后出现MODSE的重要影响因素,且69岁以上各分界年龄上下之间差异最明显,具有统计学意义(P<0.05)。结论:年龄与CHF诱发老年高血压患者发生MODSE具有一定的早期预测值,69岁以上的高血压患者如合并CHF是发生MODSE的高危人群。

The correlation of age with the risk of multiple organ dysfunction syndrome in the elderly patients with congestive heart failure and hypertension

Objective: To study the prediction value of age and congestive heart failure(CHF) for occurrence of multiple organ dysfunction syndrome elderly(MODSE) in old patients with hypertension.Methods: Medical history of 19996 cases(aged over 60 year) admitted to PLA General Hospital because of hypertension or developing hypertension during hospital stay from Jan 1993 to Dec 2008 were analyzed retrospectively.According to age the patients were divided into four groups: 60～69 year group;70～79 year group;80～89 year group;≥90 year older group.The incidence of CHF and the morbidity of MODSE induced by CHF at different ages and different boundary ages were investigated.Results: ① The incidence of MODSE in CHF cases was higher than that in the non-CHF cases(7.43% vs 3.05%,χ2 195.15,P<0.01),showing CHF were the important factor in happening of MODSE.②The incidence of CHF and the morbidity of MODSE were 10.60% vs 18.88% vs 30.11% vs 60.57%,P<0.05,P<0.05 and 1.68% vs 7.06% vs 17.08% vs 25.47%,in 60～69 year group;70～79 year group;80～89 year group;≥90 year older group,P<0.05. Occurrence of CHF and that of MODSE were positively correlated with age(r=0.696～0.987,P<0.01).High risk population of MODSE induced by CHF were old patients with hypertension above 69 year old.Conclusion: The age is valuable for early prediction of MODSE induced by CHF in old patients with hypertension.The distinctly boundary age for the incidence of MODSE induced by CHF in old patients with hypertension is 69.