真实临床实践中慢性心力衰竭患者的性别和年龄特征

E. Reznik, N. Ushakova, N. S. Ershov, E. Krupnova, E. Platonova, O.V. Gavrilova, G. Golukhov
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引用次数: 0

摘要

目的:评估和描述慢性心力衰竭(CHF)患者的性别和年龄特征。患者和方法:在这项前瞻性的回顾性研究中,作者分析了197例CHF患者的医疗记录,包括:CHF分期和功能分级、合并症和超声心动图(Echo)结果。出院24(21,28)个月后,对患者和/或其亲属进行电话随访,并审查医疗信息系统的医疗文件,以评估患者的生命状况或致死结果的原因。为了评价获得的结果,将患者按性别和年龄分组。中年组包括男性(45 ~ 59岁)和女性(45 ~ 54岁)- 18例(9.1%)。老年人组包括男性(60 ~ 74岁)和女性(55 ~ 74岁)69例(35.1%)。老年组为75岁及110岁以上(55.8%)。结果:患者年龄中位数和四分位数范围为74.7(68,82)岁。在中老年人群中,男性多于女性(χ =0.001),而在老年人群中,女性居多(χ =0.001)。男性诊断HF伴射血分数降低(HFrEF)的频率高于女性,差异有统计学意义(p=0.006)。在中度LVEF (HFmrEF)降低的HF患病率方面,男性和女性患者之间没有统计学差异。保留LVEF的HF (HFpEF)女性的诊断率高于男性,差异有统计学意义(p=0.007)。通过对不同年龄组妇女LVEF的两两比较,发现HFmrEF在中年患者中比老年患者(r =0.024)或老年患者(r =0.011)更普遍。老年妇女HFpEF患病率高于中年妇女(χ =0.012)。不同年龄组男性患者LVEF差异无统计学意义。在中老年人群中,男性和女性的合并症患病率没有显著差异。然而,在老年人中,女性合并症的发生率高于男性,差异有统计学意义(p<0.001)。结论:半数以上的CHF患者为老年人。老年组以男性居多,老年组以女性居多。在处理CHF患者、进行风险分层和选择适当治疗时,有必要考虑性别和年龄特征。关键词:慢性心力衰竭,合并症,伴发疾病,年龄范围,性别特征。引证:Reznik e.v., Ushakova n.a., Ershov N.S.等。真实临床实践中慢性心力衰竭患者的性别和年龄特征。俄罗斯医学调查。2023;7(1):13-21(俄文)。DOI: 10.32364 / 2587-6821-2023-7-1-13-21。
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Gender- and age-specific characteristics of patients with chronic heart failure in real clinical practice
Aim: to assess and describe gender- and age-specific characteristics of patients with chronic heart failure (CHF). Patients and Methods: in this retrospective study with a prospective component the authors analyzed medical records of 197 patients with CHF, including: CHF stage and functional class, co-morbidities, and echocardiography (Echo) findings. Twenty four (21, 28) months after discharging patients from the hospital, telephone follow-up calls were made to the patients and/or their relatives, and medical documentation of the medical information system was reviewed to assess the vital status of patients or the causes of lethal outcomes. For evaluating the obtained results, patients were divided into groups by gender and age. The middle-aged group comprised of males (45 to 59 years) and females (45 to 54 years) — 18 (9.1%) patients. The group of elderly persons included males (60 to 74 years) and females (55 to 74 years) — 69 (35.1%) patients. The senile group consisted of persons aged 75 years and over — 110 (55.8%) patients. Results: the median and interquartile range of patient age were 74.7 (68, 82) years. In the groups of middle-aged and elderly persons there were more men than women (р=0.001), while women prevailed in the senile group (р<0.001). The diagnosis of HF with reduced ejection fraction (HFrEF) was established more frequently in males than in females, and the difference was statistically significant (p=0.006). There were no statistically significant differences between male and female patients as regards the prevalence of HF with moderately reduced LVEF (HFmrEF). HF with preserved LVEF (HFpEF) was diagnosed more frequently in females than in males, and the difference was statistically significant (p=0.007). Using pair-wise comparison of LVEF in women of different age groups, it was shown that HFmrEF was more prevalent in middle-aged than in elderly (р=0.024) or senile (р=0.011) patients. The prevalence of HFpEF was higher in senile than in middle-aged women (р=0.012). No statistically significant differences in LVEF were found between the male patients of different age groups. There were no significant differences between males and females of middle-aged and elderly groups as regards the prevalence of co-morbidities. However, among senile persons co- morbidities were found more frequently in women than in men, and the difference was statistically significant (p<0.001). Conclusion: more than half of the patients with CHF were senile persons. Most patients with CHF in the elderly group were males, and in the senile group — females. It is necessary to consider gender and age-specific characteristics in the management of CHF patients, risk stratification and in the selection of adequate therapy. KEYWORDS: chronic heart failure, comorbidity, concomitant diseases, age ranges, gender characteristics. FOR CITATION: Reznik E.V., Ushakova N.A., Ershov N.S. et al. Gender- and age-specific characteristics of patients with chronic heart failure in real clinical practice. Russian Medical Inquiry. 2023;7(1):13–21 (in Russ.). DOI: 10.32364/2587-6821-2023-7-1-13-21.
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