冠心病慢性心力衰竭患者贫血与心功能关系的研究

Analysis of the Relationship between Anemia and Heart Function in Patients with Chronic Heart Failure Caused by Coronary Heart Disease

目的:探讨冠心病慢性心力衰竭住院患者贫血与心功能之间的相互关系。方法:整理我科2005年12月—2007年1月所有冠心病慢性心力衰竭住院患者的临床资料,根据血红蛋白(Hb)水平将患者分为贫血组和非贫血组并进行相关研究。结果:入选患者1816例,男女患者贫血的比例分别为16.34%(151/925)和17.28%(154/891)。贫血组患者的平均年龄高于非贫血组(t=6.823,P<0.01),贫血组中≥60岁的患者所占的比例高于非贫血组(χ2=13.312,P<0.01)。随着心功能分级的增高,血红蛋白水平逐渐降低,贫血的比例逐渐增高,患者心功能分级与血红蛋白之间呈负相关(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,贫血组左室射血分数(LVEF)以≤0.45的比例居多,差异均有统计学意义(P<0.05)。2组E/A≤1患者所占的比例均高于E/A>1者。结论:治疗慢性心力衰竭的同时应积极纠正贫血,可明显改善心力衰竭患者的预后。

Objective： To investigate the relationship between anemia and heart function in hospitalized patients with chronic heart failure caused by coronary heart disease. Methods： Patients with chronic heart failure caused by coronary heart disease, who were hospitalized in the Second Hospital of Tianjin Medical University between December 2005 and January 2007, were included in this study. Based on hemoglobin （Hb） levels, patients were divided into anemia group and non-anemia group. The relationship of the incidence data and the cardiac functions was retrospectively analyzed between two groups. Results： There were 1 816 patients in this study, and the proportion of male and female patients with anemia were 16.34% （151/925） and 17.28% （154/891） respectively. The average age was higher in patients of anemia group than that of the non-anemia group （t = 6.823, P 0.01）. The proportion of ≥60 years of age was higher in patients of anemia group than that of non-anemia group （χ2 =13.312,P 0.01）. With the progression of the heart function classification, the value of hemoglobin had a lower gradually trend, and the proportion of anemia had a higher gradually trend. There was a negative correlation between the heart function classification and the value of hemoglobin （ r = -0.192,P 0.05）. The value of left ventricular end diastolic diameter （LVEDD） was higher, but interventricular septum thickness （IVS） was lower, in patients of anemia group than that of non-anemia group. The majority proportion of left ventricular ejection fraction （LVEF） was ≤0.45 in patients of anemia group. The proportion of E/A≤1 was significantly higher than E/A1 in patients of two groups. Conclusion： The chronic heart failure should be treated with the correction of anemia at the same time, which could significantly improve the prognosis of patients with chronic heart failure.