摘要
目的：探讨舒张性心力衰竭（DHF）患者血红蛋白（Hb）含量的变化，贫血与左室功能的关系及对预后的影响。方法：176例DHF患者按照NYHA分级分为：Ⅱ级78例，Ⅲ级50例，Ⅳ级48例，分析各组Hb水平和贫血患病率。按照贫血诊断标准患者被分为贫血组（58例，占33.0％）与非贫血组（118例，占67.0），对两组患者左室舒张功能，随访期间的死亡率及再住院率进行比较分析。结果：贫血组随心功能分级（Ⅱ级～Ⅳ级）增加， Hb水平呈下降趋势[（130±6） g／L比（108±4） g／L比（96±12） g／L]，而贫血的患病率逐渐增加（8.97％比36.0％比68.8％）， P均＜0.05。与非贫血组相比，贫血组的冠心病患者比例（55.1％比65.5％）、肌酐[（87.6±39.2）μmol／L比（113.7±59.8）μmol／L]、N 末端 B型利钠肽原[NT‐proBNP ，（578.0±136.7） pg／ml比（886.0±174.8） pg／ml]水平明显升高，舒张早期峰速减速时间明显增加[（137±15） ms比（196±13） ms]，二尖瓣舒张早期／晚期峰值流速比值[E／A ，（0.87±0.32） 比（0.62±0.29）]明显减小（P均＜0.05）。随访期间与非贫血组比较，贫血组的死亡率（9.3％比20.7％）、再住院率（18.6％比32.8％） 明显上升（ P均＜0.05）。结论：DHF患者常伴有贫血，随着心衰严重程度的加重其贫血发病率增加，贫血可能加重心脏舒张功能不全，合并贫血的DHF患者其死亡率及再住院率增加。
Objective：To explore change of hemoglobin （Hb） concentration ,the relationship between anemia and left ventricular function and the influence of anemia on prognosis in patients with diastolic heart failure （DHF ） . Methods ：According to NYHA classification ,a total of 176 DHF patients were divided into class Ⅱ group （n=78） , class Ⅲ group （n=50） and class Ⅳ group （n=48） ,then Hb level and morbidity rate of anemia were analyzed in each group .According to diagnostic standard of anemia ,patients were divided into anemia group （n=58 ,occupied 33.0% ） and non anemia group （n=118 ,occupied 67.0% ） .Left ventricular diastolic function ,mortality rate and rehospitalization rate during follow‐up were compared and analyzed between two groups .Results：Along with cardi‐ac function class rose （from class Ⅱ to class Ⅳ） ,Hb level showed a decreasing trend [ （130 ± 6） g/L vs .（108 ± 4） g/L vs .（96 ± 12） g/L] ,while morbidity rate of anemia gradually rose （8.97% vs .36.0% vs .68.8% ） P〈0.05 all in anemia group ;Compared with non‐anemia group ,there were significant rise in percentages of patients with coro‐nary heart disease （55.1% vs .65.5% ） ,levels of creatinine [ （87.6 ± 39.2）μmol/L vs .（113.7 ± 59.8）μmol/L] and N terminal pro B type natriuretic peptide [NT‐proBNP ,（578.0 ± 136.7） pg/ml vs .（886.0 ± 174.8） pg/ml] , and early‐diastolic peak velocity deceleration time [ （137 ± 15） ms vs .（196 ± 13） ms] ,and significant reduction in mitral early/late diastolic peak flow velocity [E/A ,（0.87 ± 0.32） vs .（0.62 ± 0.29）] , P〈0.05 all .Compared with non‐anemia group , there were significant rise in mortality rate （9.3% vs .20.7% ） and rehospitalization rate （18.6%vs .32.8% ） in anemia group during follow‐up , P〈0.05 all .Conclusion：DHF patients often complicate with anemia . Along with heart failure aggravates ,their morbidity rate of anemia rises ,and anemia may aggravate cardiac diastolic dysfunction .Mortality rate and rehospitalization rate rise in DHF patients complicated with anemia .
出处
《心血管康复医学杂志》
CAS
2015年第2期119-122,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
