李海霞 羅心平 [1]* 朱軍 李劍 倪喚春 李延林 李勇 施海明 範維琥
[1]作者單位：200040 上海，復旦大學附屬華山醫院心內科
【作者簡介】李海霞，女，漢族。1981年9月23日生。河北玉田人。2007年畢業于復旦大學上海醫學院，獲內科學心血管專業碩士學位。現工作于北京市和平里醫院內科。E-mailt：agnes_lhx@hotmail.com，手機：13521271205。
摘要 目的：瞭解慢性心力衰竭（CHF）患者貧血情况。方法：回顧性調查華山醫院在2003年1月1日至2005年12月31日間出院診斷爲CHF（心功能NYHA分級II-IV級）194例患者的病史資料，爲CHF組，同期收集出院診斷爲冠心病和/或高血壓病，心功能正常、臨床特徵匹配的150例患者爲對照組。分析貧血發生情况。統計采用P檢驗及卡方檢驗。結果：CHF組紅細胞計數（RBC）及血紅蛋白（Hb）水平分別爲（4.15±0.69）×1012/L及126.34±19.28g/L，對照組爲（4.36±0.56）×1012/L及132.16±18.37g/L，兩組有顯著差异（P<0.05）。CHF組貧血發生比例較高（25.3%和14.0%，P<0.05）。CHF組亞組分析顯示：隨著心功能NYHA分級的提升，貧血發生率有升高趨勢，但差別無統計學意義。對性別、年齡、BMI、血肌酐水平、空腹血糖、高血壓、NYHA級別、LVEF進行多因素回歸分析表明：女性（OR 4.908，95%CI [1.001,24.072]，P=0.05）、老年（OR 1.178，95%CI [1.063,1.305]，P=0.002），高血肌酐水平（OR 1.066，95%CI [1.023,1.109]，P=0.002）、低體重指數（OR 0.710，95%CI [0.561,0.899]，P=0.004）更易發生貧血。結論：CHF患者中25.3%合幷貧血，且隨著NYHA級別升高，血紅蛋白有下降趨勢。女性、老年、高血肌酐水平、低體重指數爲貧血的高危人群。
關鍵詞 慢性心力衰竭 貧血
Analysis of Anemia in Patients with Chronic Heart Failure
LI Haixia,LUO Xinping,ZHU Jun,LI Jian,NI Huanchun,LI yanlin,LI yong,SHI Haiming,FAN Weihu.Department of cardiology,huashan hospital,affiliate of fudan university(Shanghai,200040,China）
Abstract Objective To analyze status of anemia in 194 patients with chronic heart failure(CHF). Methods 194 CHF patients who hospitalized in Hua Shan Hospital of Fudan University between January 2003 and December 2005 were analyzed in status of anemia, and 150 patients with hypertension and/or 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 Mean hemoglobin in patients with CHF is 126.34g/L,25.3% of whom with anemia. Erythrocyte, and hemoglobin in CHF group is lower than Control group(4.15 vs 4.36×1012/L，126.34 vs 132.16g/L， P<0.05), while the incidence rate of anemia is higher(25.3% vs 14.0%，P<0.05). After adjustment for clinical and demographic variables, the patients which being older age（OR1.178，95% confidence interval[1.063，1.305]，P=0.002）,female（OR4.908，95%CI[1.001，24.072]，P=0.05）, have high level of serum creatinine（OR1.066，95%CI[1.023，1.109]，P=0.002）、low body mass index（OR0.710，95%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 were more likely to be older, female, have high level of serum creatinine and low body mass index.
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