| 摘要: |
| 目的:了解住院慢性心衰(CHF)患者贫血患病率及其与NYHA心功能之间的相互关系,并进一步评估血红蛋白(Hb)浓度对CHF患者住院死亡率的影响.方法:回顾分析CHF患者共1 415例,排除所有可能发生继发性贫血的患者.血红蛋白(Hb)浓度对住院死亡率的影响通过多元Logistic回归分析.结果:1 415例患者中有413例贫血(29.2﹪),心功能Ⅰ级17.9﹪(5/28),Ⅱ级24.7﹪(125/507),Ⅲ级26.3﹪(151/574),Ⅳ级43.1﹪(132/306),贫血患病率与患者心功能分级之间呈正相关;严重心衰(Ⅲ级和Ⅳ级)贫血患病率(32.2﹪)与轻度心衰(Ⅰ级和Ⅱ级)贫血患病率(24.3﹪)相比有显著差异(P＜0.01).Hb水平为140～159 g/L的患者住院死亡率最低,Hb水平＜80 g/L、80～99 g/L、100～119 g/L、120～139 g/L及≥160 g/L的患者住院死亡率增高,呈U形曲线关系.对于Hb＜160 g/L的心衰患者,通过多元Logistic回归分析,调整了年龄、性别、基础病因、糖尿病、心功能分级、血清肌酐浓度等因素的影响,Hb水平对住院死亡率仍是一个独立的影响因子.结论:住院CHF患者中贫血相当普遍,贫血与心衰的严重程度密切相关,Hb水平显著影响CHF患者的住院死亡率,Hb水平＜160 g/L是CHF患者住院死亡率独立的影响因子. |
| 关键词: 慢性心力衰竭、贫血、心功能、血红蛋白、医院死亡率 |
| DOI：10.3724/SP.J.1008.2006.00977 |
| 投稿时间：2006-01-12修订日期：2006-06-05 |
| 基金项目: |
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| Relationship between prevalence of anemia and cardiac function in hospitalized patients with chronic heart failure and influence of hemoglobin level on their mortalities |
| YE Chang-qing,ZHENG Xing |
| (第二军医大学长海医院心血管内科,上海,200433) |
| Abstract: |
| Objective： To investigate the relationship between the prevalence of anemia and New York Heart Association （NYHA） class in patients with chronic heart failure （CHF）, and to assess the influence of hemoglobin （Hb） on patients＇ mortality. Methods： Totally 1 415 patients with CHF were retrospectively analyzed and the patients with secondary anemia or other serious conditions were excluded. Multivariable logistic analysis was used to assess the effect of Hb level on hospital mortality. Results： Among 1 415 patients, 413 （29.2%） were found to have anemia （Hb〈120 g/L）. The prevalence of anemia was positively correlated with the NYHA-class of patients （ NYHA-class I 17. 9% [5/28], class Ⅱ 24. 7% [125/507] , class Ⅲ 26.3% [151/574], and class Ⅳ 43.1% [132/306]. Patients with severe heart failure （ NYHA-class Ⅲ and IV [32.2%]） had a significantly higher prevalence of anemia than patients with slight heart failure （class I and Ⅱ [24.3%], P〈0.01）. Patients with a Hb level of （140-159） g/L had the lowest hospital mortality, and those with Hb levels 〈80 g/L, （80-99） g/L, （100- 119） g/L, （120-139） g/L, and≥160 g/L had higher hospital mortalities. The relationship between mortality and Hb level was in a U-shaped manner. For patients with Hb level 〈160 g/L, multivariable logistic analysis showed that Hb remained as an in- dependent predictor of the hospital mortality when the influences of the age, gender, basic cause of the disease, diabetes, cardiac function classification, serum creatinine, etc. were adjusted. Conclusion： Anemia is a common condition in hospitalized CHF patients and the degree of anemia is closely correlated with the severity of CHF. Hb level significantly influences the patients＇ hospital mortality. Hb level （〈160 g/L） is an independent predictor of hospital mortality in the patients with CHF. |
| Key words: chronic heart failure anemia cardiac function hemoglobin hospital mortality |
