194例慢性心力衰竭患者贫血状况的临床分析

Analysis of Anemia in 194 Patients with Chronic Heart Failure

目的:了解慢性心力衰竭(CHF)患者贫血情况。方法:回顾性调查华山医院2003年1月-2005年12月出院诊断为CHF(心功能NYHA分级Ⅱ～Ⅳ级)194例患者的病史资料,为CHF组,同期收集出院诊断为冠心病和(或)高血压病,心功能正常、临床特征匹配的150例患者为对照组。分析贫血发生情况。结果:CHF组红细胞计数(RBC)及血红蛋白(Hb)水平分别为(4.15±0.69)×1012/L及(126.34±19.28)g/L,对照组为(4.36±0.56)×1012/L及(132.16±18.37)g/L,两组比较差异有统计学意义(P<0.05)。CHF组贫血发生比例较高为25.3%,对照组为14.0%(P<0.05)。CHF组亚组分析显示:随着心功能NYHA分级的提升,贫血发生率有升高趋势。对性别、年龄、BMI、血肌酐水平、空腹血糖、高血压、NYHA级别、LVEF进行多因素回归分析表明:女性OR4.908,95%CI[1.001,24.072],P=0.05,老年OR1.178,95%CI[1.063,1.305],P=0.002,高血肌酐水平OR1.066,95%CI[1.023,1.109],P=0.002,低体重指数OR0.710,95%CI[0.561,0.899],P=0.004,更易发生贫血。结论:CHF患者中25.3%合并贫血,且随着NYHA级别升高,血红蛋白有下降趋势。女性、老年、高血肌酐水平、低体重指数为贫血的高危人群。

Objective ：To analyze status of Anemia in 194 patients with chronic heart failure（CHF）.Methods ：194 CHF patients who hospitalized in Huashan Hospital of Fudan University between January 2003 and December 2005 were analyzed in status of anemia, and 150 patients with hypertension and coronary artery disease （CAD） were as control group which had normal cardiac function and were hospitalized.The clinic data were retrospectively collected from medical records.Statistical associations between CHF and anemia were assessed through the use of 1-way ANOVA, T test and Chi-square test, taking P〈0.05 to be significant. Results ： Erythrocyte and hemoglobin in CHF group was lower than the control group （4.15 ＋ 0.69） x 1012/L vs （4.36 _＋ 0.56） x 1012/L, （126.34 ＋ 19.28）g/L vs （132.16＋ 18.37）g/L（P〈0.05）, while the incidence rate of anemia is higher 25.3% vs 14.0%（P〈0.05）.Along with the ascension of the heart function NYHA classification, the anemia rate had rise trend.After adjustment for clinical and demographic variables, the patients which being older age OR 1.178, 95% confidence interval[1.063, 1.305],P=0.002, female OR 4.908,95%CI[1.001,24.072],P=0.05, have high level of serum creatinine OR 1.066, 95%CI[1.023, 1.109], P=0.002, low body mass index OR 0.710, 95%CI[0.561, 0.899], P=0.004, were more likely to have anemia.Conclusion ：25.3% patients with chronic heart failure had anemia.As NYHA grade elevated, erythrocyte and hemoglobin decreased, the incidence rate of anemia increased.Patients with anemia are more likely to be older, female, have high level of serum creatinine and low body mass index.