CAJ | 학술논문

目的：比较舒张性心功能衰竭（心衰）和收缩性心衰患者在临床表现及危险因素方面的差异。方法将2088例心衰患者按左室射血分数（EF）分为舒张性心衰组（EF≥0.45，1356例）和收缩性心衰组（EF＜0.45，732例），比较2组的临床资料，分析影响2种心衰类型的相关因素。结果与收缩性心衰组相比，舒张性心衰组的平均年龄更大，女性及高血压的比例更高，但低蛋白血症、贫血、肾功能不全、高尿酸血症的比例更低，且以心功能Ⅰ、Ⅱ级为主；收缩压、白蛋白、前白蛋白、胆固醇、血钠、血氯水平更高，但心率更慢，肌酐、血尿酸、血钾、脑钠肽水平更低。与收缩性心衰组相比，舒张性心衰组的左室舒末容积、左室缩末容积较低，RAS阻断剂和β受体阻断剂使用率更低，他汀类药物使用率更高。Logistic多因素回归分析发现，性别、高血压对舒张性心衰影响更强；低蛋白血症、高尿酸血症则对收缩性心衰影响更强。结论舒张性心衰和收缩性心衰存在诸多差异，不同类型的心衰需采取不同的诊治及预防方案。
목적：비교서장성심공능쇠갈（심쇠）화수축성심쇠환자재림상표현급위험인소방면적차이。방법장2088례심쇠환자안좌실사혈분수（EF）분위서장성심쇠조（EF≥0.45，1356례）화수축성심쇠조（EF＜0.45，732례），비교2조적림상자료，분석영향2충심쇠류형적상관인소。결과여수축성심쇠조상비，서장성심쇠조적평균년령경대，녀성급고혈압적비례경고，단저단백혈증、빈혈、신공능불전、고뇨산혈증적비례경저，차이심공능Ⅰ、Ⅱ급위주；수축압、백단백、전백단백、담고순、혈납、혈록수평경고，단심솔경만，기항、혈뇨산、혈갑、뇌납태수평경저。여수축성심쇠조상비，서장성심쇠조적좌실서말용적、좌실축말용적교저，RAS조단제화β수체조단제사용솔경저，타정류약물사용솔경고。Logistic다인소회귀분석발현，성별、고혈압대서장성심쇠영향경강；저단백혈증、고뇨산혈증칙대수축성심쇠영향경강。결론서장성심쇠화수축성심쇠존재제다차이，불동류형적심쇠수채취불동적진치급예방방안。
Objective To analyze the differences in clinical characteristics and risk factors in patients with diastolic heart failure and systolic heart failure. Methods A total of 2 088 patients with heart failure were divided into two groups, diastolic heart failure group (EF≥0.45,n=1 356) and systolic heart failure group (EF<0.45,n=732), according to ejection fraction (EF). The clinical features and related factors affecting the two types of heart failure were compared between two groups. Results There were higher age, higher proportion of women and higher proportion of hypertensive patients in dia?stolic heart failure group than those of systolic heart failure group, but lower rates of hypoalbuminemia, anemia, renal insuffi?ciency and hyperuricimia. There was higher incidence of functional class I and II in diastolic heart failure group. And com?pared with systolic heart failure group, there were higher levels of systolic blood pressure, albumin, prealbumin, cholesterol, sodium and serum chloride in diastolic heart failure group, but lower levels of heart rates, creatinine, blood uric acid, potassi?um and brain natriuretic peptide. Compared with systolic heart failure group, there were lower left ventricular end diastolic volume (LVEDV) and left ventricular end systolic volume (LVESV) in diastolic heart failure group. And there were lower RAS blocker andβ-blocker usage, higher statin usage in diastolic heart failure group. Logistic regression analysis showed that gender and hypertension were significantly correlated with diastolic heart failure, and hypoalbuminemia and hyper?uricimia were significantly correlated with systolic heart failure. Conclusion Our results show that there are differences in clinical features and risk factors in patients with diastolic heart failure and systolic heart failure. We should take the differ?ent treatment and prevention programs for the two kinds of heart failures.