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目的了解辽宁省农村地区慢性心力衰竭(CHF)的患病率和诊治情况。方法按整群随机抽样方法,于2008年在辽宁省6个县抽取具有代表性的人群样本,年龄在25～95岁,男女人数均衡。统计不同年龄组、不同性别人群的CHF患病率及诊治情况。结果(1)共抽样调查33027人,CHF患病率为1.61%;其中男性为0.95%,女性为2.28%,女性患病率高于男性(P<0.005)。25～35岁、>35～45岁、>45～55岁、>55～65岁、65～75岁年龄组的CHF患病率分别为0.12%、0.79%、1.98%、3.71%和7.51%;随着年龄增高,CHF的患病率显著上升(P<0.005)。(2)CHF病因分布情况:冠心病(68.36%)、高血压病(13.37%)、心肌病(6.99%)、风湿性瓣膜病(3.95%)、先天性心脏病(1.69%),其他心血管病占(5.27%)。与既往基础资料相比,冠心病所占比例明显升高,居病因首位;高血压、心肌病的患病率呈缓慢上升趋势;而风湿性心瓣膜病所占比例继续下降,由2000年的18.6%降至3.95%,在CHF的病因中退居第4位。(3)CHF患者标准治疗药物使用情况为:螺内酯0.38%;血管紧张素转换酶抑制剂(ACEI)4.33%;β-受体阻滞剂3.77%。结论辽宁省农村CHF的患病情况明显高于既往流行病学调查数据,冠心病所占比例呈持续上升,各种标准治疗药物的应用都极其有限,绝大部分CHF患者未得到规范化系统化的治疗。有关卫生决策部门应加强我国农村CHF患者的治疗与管理。
Objective To investigate the prevalence and diagnosis and treatment of chronic heart failure (CHF) in rural areas of Liaoning Province. Methods According to the cluster random sampling method, a representative sample of the population was collected from 6 counties in Liaoning Province in 2008, aged 25-95 years. The number of men and women was balanced. Statistics of different age groups, gender differences in the prevalence of CHF and diagnosis and treatment. Results (1) A total of 33027 people were sampled and the prevalence of CHF was 1.61%. Among them, the incidence rate of CHF was 0.95% in males and 2.28% in females, and the prevalence rate in females was higher than that in males (P <0.005). The prevalences of CHF at 25-35,> 35-45,> 45-55,> 55-65, 65-75 age groups were 0.12%, 0.79%, 1.98%, 3.71%, and 7.51%, respectively, The prevalence of CHF increased significantly with age (P <0.005). (2) The distribution of CHF: CHD (68.36%), hypertension (13.37%), cardiomyopathy (6.99%), rheumatic valvular disease (3.95%), congenital heart disease (1.69%), other heart Vascular disease accounted for (5.27%). Compared with the previous basic data, the proportion of coronary heart disease was significantly increased, ranking the first cause; the prevalence of hypertension and cardiomyopathy showed a slow upward trend; while the proportion of rheumatic valvular heart disease continued to decline from 2000 18.6% to 3.95%, ranking fourth in the etiology of CHF. (3) The standard treatment of CHF patients: Spironolactone 0.38%; angiotensin converting enzyme inhibitor (ACEI) 4.33%; β-blockers 3.77%. Conclusions The prevalence of CHF in rural areas of Liaoning Province was significantly higher than that of the previous epidemiological survey. The proportion of coronary heart disease continued to rise. The application of various standard therapeutic drugs was extremely limited. The majority of CHF patients were not standardized and systematic treatment. Relevant health decision-making departments should strengthen the treatment and management of rural patients with CHF in our country.