摘要
目的探讨血红蛋白（Hb）水平对老年急性心肌梗死（AMI）患者PCI后临床预后的影响。方法选择首次发生AMI和老年患者414例，根据Hb水平按四分位法分威4组：最低四分位组（A组，32例）Hb水平〈80g／L；第2个四分位组（B组，115例）：Hb水平为80～100g／L；第3个四分位组（C组，217例）：Hb水平为101～120g／I。；最高四分位组（D组，50例）：Hb水平〉120g／L。入院时均行急诊PCI，随访30天和1年。结果老年AMI患者Hb水平与糖尿病、高血压、高龄、内生肌酐清除率和LVEF减低的发生率明显相关，Hb水平越低，PCI术后30天和1年的全因病死率、心源性病死率、非心源性病死率、心功能恶化率越高，4组比较差异有统计学意义（P〈0．01）。Hb水平对血脂、冠状动脉病变累及血管数、心肌再梗死率无显著差异；对Hb〈130g／L的PCI术后患者，调整了年龄、血脂、糖尿病、心功能等因素的影响后，Hb水平与30天和1年的病死率明显相关（P〈0．01）。结论贫血是老年AMI患者PCI术后30天和1年病死率一个独立预测因素。
Objective To assess retrospectively the impact of anaemia on prognosis of aged patients with acute myocardial infarction（AMI） after percutaneous coronary intervention（PCI）. Methods 414 aged patients with AMI were divided into four groups（group A： hemoglobin〈80 g/L; group g：hemoglobin 80--100 g/L; group C： hemoglobin 101 - 120 g/L; group D： hemoglobin〉120 g/L） depending on the level of hemoglobin. The patients were treated with PCI on admission and followed up for 30 days and one year. Results In elderly AMI patients,the Hb level was significantly correlated with diabetes, hypertension, advanced age, endogenous creatinine clearance and reduction of LVEF. The lower the Hb level,the higher the mortality due to all causes,cardiogenic death,non-cardiogenic death and rate of heart failure during one-month and one-year followup. There was statistical significance among four groups （P〈0.01）. However,the level of hemoglobin had no significant impact on blood lipid,the number of atherosclerotic coronary arteries and the rate of recurrent myocardial infarction. For the AMI patients with hemoglobin〈130 g/L treated with PCI,after adjusted for factors including age, blood lipid, diabetes and cardiac function, the level of hemoglobin was still correlated with the mortality in 30 days and one year. Conclusion Anaemia is an independent predictive factor of the mortality of aged patients with AMI during 30 days and one year after PCI.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2008年第10期748-750,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
血红蛋白类
贫血
心肌梗塞
预后
危险因素
hemoglobins
anemia
myocardial infarction
prognosis
risk factors
