老年高血压患者发生射血分数保留心衰的危险因素分析

摘要

目的:探讨伴随老年高血压患者发生射血分数保留心衰(ejection fraction preserve heart failure,EFpHF)的危险因素,以期为该类患者的治疗及预防提供参考.方法:分析96例HFpEF合并高血压患者的临床资料,并列为观察组;对照组101例为高血压合并射血分数正常非心衰患者.对可能影响HFpEP患者疾病发生及发展进程的因素进行单因素分析,对具有差异的指标进一步采用多因素Logistic回归分析,得出具有影响该病的独立危险因素.结果:两组患者在性别比例、年龄、体质指数(BMI)、吸烟比较上,差异均有统计学意义(P<0.05);两组患者在房颤、糖尿病、冠心病、肾功能不全、贫血、呼吸睡眠暂停病史水平发生率比较上,差异均有统计学意义(P <0.05);HFpEF 合并高血压患者不同心功能分级 LEVF、LVDd、LVST、E/A、LAV及血清NT-proBNP水平比较,差异均有统计学意义(P<0.05).HFpEF患者随着心功能升高LVDd、LVST、LAV及血清NT-proBNP水平升高,LEVF、E/A水平呈下降趋势;高龄、超重、吸烟、糖尿病、冠心病是HFpEF合并高血压患者发病的危险因素.结论:高龄、超重、吸烟、糖尿病、冠心病是HFpEF合并高血压患者发病的危险因素,心功能分级越严重,心肌重构、心房功能改变就越明显.%Objective:To investigate the risk factor of ejection fraction preserve heart failure in elderly hypertensive patients,in order to provide reference for the treatment and prevention of this kind of patients in clinical practice.Methods:The clinical data of 96 patients with HFpEF combined with hypertension were analyzed and included in the observation group.The 101 patients in the control group were hypertensive patients with normal ejection fraction and non-heart failure.The univariate analysis was performed on the factors that may influence the occurrence and development of the disease in HFpEP patients.Multivariate logistic regression analysis was used to analyze the indicators with differences,and independent risk factors affecting the disease were obtained.Results:There were signifi-cant differences in gender,age,body mass index(BMI) and smoking comparison between the two groups(P<0.05).There ware sig-nificant differences in the incidence of atrial fibrillation,diabetes,coronary heart disease,renal insufficiency,anemia,and respiratory ap-nea history between the two groups (P<0.05).The levels of LEVF,LVDd,LVST,E/A,LAV and serum NT-proBNP in patients with HFpEF and hypertension were significantly different (P<0.05).In patients with HFpEF,the levels of LVDd,LVST,LAV and serum NT-proBNP increased with the increase of cardiac function,and the levels of LEVF and E/A decreased.Older age,overweight,smoking, diabetes,and coronary heart disease were risk factors for the onset of HFpEF in patients with hypertension.Conclusion:Older age,over-weight,smoking,diabetes mellitus,and coronary heart disease are risk factors for the onset of HFpEF in patients with hypertension.The more serious the cardiac function class is,the more obvious the changes of myocardial remodeling and atrial function are.