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目的：评价射血分数（EF）正常性心力衰竭患者的流行病学特点及其3 年预后，并与EF 降低性心力衰竭患者进行比较。方法：选择2005-1 至2006-12 二所三甲医院心内科收治的461 例慢性心衰患者，根据入院时左室EF 分为EF 正常组（EF>=50%）和 EF 降低组（EF<50%），进行为期3 年的电话随访；终点事件包括全因死亡、心衰加重再住院。结果：慢性心衰患者中EF 正常234 例（50.7%），与EF 下降患者比较，这类患者中较为高龄、多为女性；病因多为瓣膜病、高血压病及房颤；随访结果显示二组患者的终点事件发生率并无明显差异（P=0.578),Cox 回归分析对其它因素校正后发现，房颤(RR=1.301, 95%CI: 0.995-1.701, P＜0.05)、年龄(RR=1.012, 95%CI: 1.003-1.022, P＜0.05)是影响慢性心衰患者3 年预后的主要因素。结论：在慢性心衰中，EF 正常的患者预后与EF 下降者相似，对这类病人同样应加强监测及治疗。

英文摘要:

Objective: To evaluate the epidemiologic features and prognosis of patients with chronic heart failure (CHF) with preserved ejection fraction (EF) and to compare with the patients who had CHF with reduced EF. Methods: From January, 2005 to December, 2006 we studied 461 patients with a discharge diagnosis of CHF. Patients were devided by baseline EF in preserved EF (EF>=50%) and reduced EF(EF<50%) group. The main endpoints were all cause death within 3 years and readmission to the hospital for heart failure. Results: Two hundreds and thirty four patients (50.7%) had an EF of more than 50%. During 3 year follow-up, the main endpoints was similar in two groups (P=0.578); After adjusting for other covariables, AF and advanced age were related to increased the risk of main endpoints during 3 years follow-up (RR=1.301, 95%CI: 0.995-1.701, P＜0.05; RR=1.012, 95%CI: 1.003-1.022, P＜0.05). Conclusions: The prognosis of patients with CHF with preserved EF was similar to that of patients with reduced EF. Therapy and monitor should be proven in these patients.

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