慢性心力衰竭合并贫血的临床分析

Analysis of anemia in chronic heart failure

目的通过回顾性分析湖南省人民医院心内科住院诊治的慢性心衰（CHF）患者病例资料，了解人群中贫血发病状况、特点及两者之间的关联。方法收集2012年10月至11月在湖南省人民医院住院、出院诊断为CHF患者259例，根据心功能情况分为心功能I一Ⅳ级，分析贫血发生情况及发病特点。结果（1）慢性心衰患者贫血组年龄、冠心病发生率、糖尿病发生率、红细胞、血红蛋白、血细胞比容、肌酐、白蛋白、总胆固醇、心功能分级与非贫血组比较，差异均有统计学意义（P〈0．05）。（2）Logistic回归分析得出：年龄（95％Cl：1．123～3．580，P〈0．05）、肌酐（95％CI：1．320-4．845，P〈0．05）、心功能分级（95％CI：1．368—3．385，P〈0．05）均是心衰患者发生贫血的重要危险因素。结论慢性心衰患者合并贫血在临床上较常见，且心功能越差，血红蛋白越低，贫血发生率越高；慢性心衰患者合并贫血时肾功能、营养状况均较差；年龄、肾功能不全及心功能分级是慢性心衰患者发生贫血的重要危险因素。

Objective To investigate the correlation between the incidence and characteristics of anemia in chronic heart failure population through retrospective analysis of patients hospitalized at the Hunan Provincial People＇s Hospital. Methods A total of 259 patients who were diagnosed as chronic heart failure （CHF） and hospitalized at the Hunan Provincial People＇s Hospital from October to November in 2012 was collected, and divided into cardiac function I ～ Ⅳ grade, then their clinical characteristics was analyzed. Results （1）Compared with CHF patients without anemia, the creatinine value was significantly higher, the percentage of patients with severe heart failure was significantly higher in the CHF patients with anemia （ P 〈 0. 05 ）. （2） Logistic regression analysis demonstrated that age （95% CI ： 1. 123 ～ 3. 580, P 〈 0.05 ）, renal insufficiency （95% CI ： 1.320 ～4.845, P 〈0.05） , and cardiac function （95% CI ： 1.368 ～3.385, P 〈 0.05 ） in patients with heart failure were important risk factors for anemia. Conclusions Anemia was common in CHF patients. The poorer cardiac function was and the lower hemoglobin was, the higher incidence of anemia was. The patients with anemia had the characteristics of worse renal function and poorer nutritional status compared patients without anemia. Age, renal insufficiency, and cardiac function were im- portant risk factors for anemia.