老年射血分数保留型心力衰竭患者不同性别相关因素分析及增强型体外反搏安全性观察

黄鑫; 孔红娇; 朱明娜; 黄琳凯; 杨瑜; 任笑盈; 张辉

doi:10.16766/j.cnki.issn.1674-4152.001862

老年射血分数保留型心力衰竭患者不同性别相关因素分析及增强型体外反搏安全性观察

doi: 10.16766/j.cnki.issn.1674-4152.001862

黄鑫¹,
孔红娇²,
朱明娜¹,
黄琳凯³,
杨瑜⁴,
任笑盈³,
张辉^1, ,

1.
郑州大学第二附属医院心血管内科，河南郑州 450014
2.
郑州大学第三附属医院生殖医学中心，河南郑州 450052
3.
郑州大学第二附属医院消化内科，河南郑州 450014
4.
郑州大学第二附属医院肿瘤科，河南郑州 450014

基金项目:

河南省医学科技攻关计划重点项目 201402019

河南省医学科技攻关计划省部共建项目 201601008

详细信息

通讯作者:
张辉, E-mail: zzzjs@163.com

中图分类号: R541.6
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- 文章访问数: 248
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- PDF下载量: 4
- 被引次数: 0
出版历程
- 收稿日期: 2020-06-15
- 网络出版日期: 2022-02-16

Analysis of different gender-related factors and observation of the safety of enhanced external counterpulsation in elderly patients with heart failure and preserved ejection fraction

1.
Department of Cardiology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, China

摘要

摘要: 目的探讨老年射血分数保留型心力衰竭(heart failure with preserved ejection fraction, HFpEF)患者不同性别相关因素及临床特点，并对比增强型体外反搏(enhanced external counterpulsation, EECP)治疗不同性别老年HFpEF患者的安全性。方法收集2019年1月—2020年1月在郑州大学第二附属医院接受EECP治疗并明确诊断为HFpEF的老年患者(≥65岁)200例，根据性别分为男性组(88例)和女性组(112例), 记录入组患者一般临床资料(年龄、BMI、吸烟史、既往史等)、检验检查资料[NYHA心功能分级、肾功能、左室射血分数(left ventricular ejection fraction, LVEF)、BNP等]，并对比不同性别老年HFpEF患者行EECP治疗时的不良反应事件发生情况。结果老年HFpEF女性组患者人数明显多于男性组(56% vs. 44%)，且患病年龄、BMI、LVEF大于男性组(均P < 0.05)，NYHA心功能分级女性组患者Ⅲ级和Ⅳ级多于男性组。老年HFpEF男性组患者吸烟史人数多于女性组(P < 0.05)，NYHA心功能分级男性组患者Ⅰ级和Ⅱ级多于女性组。相关因素分析显示：肥胖、房颤、高血压、LVEF等因素与女性组患者相关性较强(均P < 0.05)；吸烟史、高脂血症等因素与男性组患者相关性较强(均P < 0.05)。不同性别HFpEF患者EECP治疗不良反应发生率比较差异无统计学意义(7.95% vs. 9.82%，P > 0.05)。结论老年HFpEF患者一般资料及合并症存在性别差异，且老年女性HFpEF患者临床特点独特，但EECP针对不同性别老年HFpEF患者安全性相近。
- 射血分数保留型心力衰竭 /
- 增强型体外反搏 /
- 心力衰竭 /
- 安全性 /
- 性别
Abstract: Objective This study aimed to explore the gender-related factors and clinical characteristics of elderly patients with heart failure and preserved ejection fraction (HFpEF) and compare the safety of enhanced external counterpulsation (EECP) in the treatment of elderly patients with HFpEF of different genders. Methods A total of 200 elderly patients (≥65 years old) who received EECP treatment at the Second Affiliated Hospital of Zhengzhou University from January 2019 to January 2020 and were diagnosed with HFpEF were divided into the male group (n=88) and female group (n=112) according to gender. General clinical data (age, BMI, smoking history and past history), inspection data [NYHA cardiac function grade, renal function, left ventricular ejection fraction (LVEF) and Brain Natriuretic Peptide], BNP were recorded, and the adverse reactions of the elderly HFpEF patients of different gender were compared after EECP treatment. Results The number of elderly women with HFpEF was significantly higher than that of men (56% and 44%, P < 0.05), and the age of disease, BMI and LVEF were greater than that of men (all P < 0.05). There are more patients in the NYHA heart function class Ⅲ and Ⅳ in the female group than in the male group; the number of elderly male HFpEF patients with smoking history was greater than that of females (P < 0.05), and there are more patients in the NYHA cardiac function classification of grade Ⅰ and Ⅱ in the male group than in the female group. Analysis of related factors showed that obesity, atrial fibrillation, hypertension and LVEF have a strong correlation with the female group (all P < 0.05); smoking history and hyperlipidaemia have a strong correlation with the male group (P < 0.05). The incidence of adverse reactions in different gender groups of EECP treatment for HFpEF was not statistically significant (7.95% vs. 9.82%, P > 0.05). Conclusion Gender differences in the relevant factors of elderly HFpEF patients are found, and the clinical characteristics of elderly female HFpEF patients are unique, but EECP has the same safety for elderly HFpEF patients of different gender.
- Heart failure with preserved ejection fraction /
- Enhanced external counterpulsation /
- Heart failure /
- Safety /
- Gender

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表 1 不同性别组老年HFpEF患者一般资料比较(x ±s)

组别	例数	年龄(岁)	BMI	吸烟史[例(%)]	LVEF (%)	NYHA心功能分级[例(%)]				BNP [M(P₂₅，P₇₅)，pg/mL]	血肌酐(mmol/L)	血尿素氮(mmol/L)
组别	例数	年龄(岁)	BMI	吸烟史[例(%)]	LVEF (%)	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	BNP [M(P₂₅，P₇₅)，pg/mL]	血肌酐(mmol/L)	血尿素氮(mmol/L)
男性组	88	73.61±8.04	25.95±4.61	50(56.8)	57.98±4.32	10(11.4)	46(52.3)	25(28.4)	7(8.0)	468.0(202.9, 1 030.0)	96.05±58.84	7.92±4.53
女性组	112	76.30±7.38	28.63±5.50	18(16.1)	59.72±4.40	7(6.3)	42(37.5)	46(41.1)	17(15.2)	538.2(239.7, 1 239.7)	85.36±52.92	7.27±4.07
统计量		2.460^a	3.674^a	36.461^b	2.807^a	-2.855^c				4 527.500^d	1.350^a	1.053^a
P值		0.015	< 0.001	< 0.001	0.005	0.004				0.324	0.179	0.293
注：^a为t值，^b为χ²值，^c为Z值，^d为U值。

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表 2 不同性别老年HFpEF患者合并疾病比较[例(%)]

组别	例数	冠心病	高血压	糖尿病	房颤	高脂血症	其他疾病
男性组	88	60(68.2)	45(51.1)	29(33.0)	21(23.9)	67(76.1)	38(43.2)
女性组	112	55(49.1)	85(75.9)	37(33.0)	42(37.5)	65(58.0)	61(54.5)
χ²值		7.337	13.276	< 0.001	4.247	7.195	2.509
P值		0.007	< 0.001	0.990	0.039	0.007	0.113

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表 3 不同性别老年HFpEF患者EECP治疗不良反应事件发生情况比较[例(%)]

组别	例数	气囊不适	噪音影响	皮肤破损	总计
男性组	88	4(4.55)	2(2.27)	1(1.14)	7(7.95)
女性组	112	6(5.36)	3(2.68)	2(1.79)	11(9.82)
χ²值		0.068	0.033	0.141	0.210
P值		0.794	0.855	0.708	0.647

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