贫血对左心室射血分数保留型心力衰竭患者生存状况的影响

Effect of anemia on clinical outcomes in patients with heart failure with preserved ejection fraction

目的探讨贫血对射血分数保留型心力衰竭（HFPEF）患者预后生存状况的影响。方法选择在我院住院治疗的HFPEF患者325例,分为贫血组84例和无贫血组241例,收集临床资料,以全因死亡或心力衰竭再住院为终点事件,定期随访9～26（17.5±8.3）个月,用Kaplan-Meier生存曲线和Cox比例风险回归模型分析。结果贫血组终点事件发生率明显高于无贫血组（67.9%vs 48.1%,P=0.002）。贫血患者中位生存时间较无贫血患者明显降低（16个月vs 21个月,P=0.019）。贫血是影响预后的独立危险因素（OR=5.012,95%CI：3.271～6.160,P=0.006）。结论贫血是影响HFPEF患者预后的独立危险因素,在HFPEF患者诊治过程中应当予以高度重视。

Objective To assess the effect of anemia on clinical outcomes in patients with heart fail- ure with preserved ejection fraction （HFPEF） by studying the clinical features of HFPEF. Meth- ods Three hundred and twenty-five HFPEF patients admitted to our hospital were divided into anemia group （n=84） and non-anemia group （n= 241）. Their clinical and laboratory data were collected. The patients were followed up for 9- 26 （17. 5 ±8. 3） months. The risk factors for HFPEF were analyzed using Kaplan-Meier survival curve and Cox proportional hazard regression model. Results The all-cause death rate or end point events during rehospitalization due to HF was significantly higher in anemia group than in non-anemia group （67. 9% vs 48. 1%, P = 0. 002）. Anemia, NYHA grade and chronic renal insufficiency were the independent risk factors for HFPEF,and anemia was the most powerful influence factor （OR= 5. 012,95%CI： 3. 271-- 6. 160,P=0. 006）. Conclusion Anemia is an independent risk factor for HFPEF,and more atten- tion should thus be paid to anemia in diagnosis and treatment of HFPEF.