天津医药

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冠心病慢性心力衰竭患者贫血与心功能关系的研究

赵媛媛,王林,宋芳,郭慧卿   

  1. 天津医科大学第二医院
  • 收稿日期:2010-08-20 修回日期:2010-12-01 出版日期:2011-04-15 发布日期:2011-04-15
  • 通讯作者: 赵媛媛

Analysis on the relationship between anemia and heart function in hospitalized patients with chronic heart failure caused by coronary heart disease

  • Received:2010-08-20 Revised:2010-12-01 Published:2011-04-15 Online:2011-04-15
  • Contact: Yuan-Yuan ZHAO

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摘要： 目的：了解冠心病慢性心衰住院患者贫血的发病情况，及与心功能之间的相互关系。方法：通过整理天津医科大学第二医院心脏科2005年12月——2007年1月所有冠心病慢性心衰住院患者的临床资料，回顾性分析其贫血的发病情况及与心功能之间的关系。结果：入选患者1816例，性别分布无统计学差异（χ2=0.637 ，p>0.05）。其中合并贫血者16.80%（305/1816）男女患者中贫血的比例分别为16.34%（151/925）、7.28 % (154/891)，两者之间无统计学差异(p>0.05)。贫血组患者的平均年龄高于非贫血组（t=6.823,P<0.01），≥60岁的患者中贫血的比例明显的高于年龄<60岁的患者（χ2=13.312，p<0.01）。随着心功能分级的增高,血红蛋白的值呈逐渐降低的趋势，贫血的比例呈逐渐增高的趋势，心功能分级与患者的血红蛋白之间呈负性相关关系( r=-0.192，p<0.05)。贫血组患者的左室舒张末期内径（LVEDD）大于非贫血组，室间隔厚度（IVS）则小于非贫血组，其左室射血分数（LVEF）以≤45％的比例居多，而非贫血组LVEF则以>45%的比例居多。两组均以E/A≤1的比例多于E/A>1的比例，而且，非贫血组E/A≤1的比例多于贫血组，差异均有统计学意义。结论：冠心病慢性心衰患者常常合并贫血，而贫血又能加重CHF患者的病情，增加病死率，形成恶性循环，因此治疗CHF的同时应积极纠正贫血，可明显改善心衰患者的预后。

关键词: 冠心病, 慢性心衰, 贫血, 左室射血分数, 心功能分级

Abstract: Objective: To investigate the relationship between anemia and heart function in hospitalized patients with chronic heart failure caused by coronary heart disease. Methods : 1816 patients which were hospitalized between Dec 2005 and Jan 2007 in the second hospital of Tianjin medical university were analyzed. The retrospective indexes include anemia, heart function. Results: 1816 cases were enrolled and the distribution of gender has no statistical significance. Among these cases, 305(13.8%) were found to have anemia ,the proportion of which in male and female is 16.34%（151/925）and .28 % (154/891) respectively (p>0.05)．The average age in anemia set is older than that of the non-anemia set (t=6.823,P<0.01).The proportion of anemia in over 60 years elders is higher than that of under 60 years elders(χ2=13.312，p<0.01) . With the progression of heart function classification, the value of hemoglobin has a lower gradually trend, the prevalence of anemia has a higher gradually trend. Between heart function classification and the value of hemoglobin take the negative relationship ( r=-0.192，p<0.05) .LVEDD of anemia set is higher than the non-anemia, IVS is lower. Anemia set has a majority proportion of LVEF(≤45%),while, LVEF in non-anemia set is mainly ＞45%.The proportion of E/A≤1 is more than E/A>1 in both sets and E/A≤1 is more in non-anemia set, these differences all have statistic significant. Conclusion: Coronary Chronic Heart Failure usually accompanies with anemia, and then anemia can make the degree of CHF aggravate, increase the hospital mortality and form vicious circle. Therefore while in the treatment of heart failure, we should actively correct anemia, this can significantly improve the prognosis of patients with Chronic Heart Failure.

Key words: Coronary Heart Disease, Chronic Heart Failure, Anemia, Left Ventricular Ejection Fraction, Heart Function Classification