慢性贫血对冠心病患者血运重建术后院内结果的影响  

Impact of chronic anemia on in-hospital clinical outcome of revascularization in patients with coronary artery disease

作　　者：阙斌[1] 马长生[1] 聂绍平[1] 董建增[1] 吴学思[1] 刘晓慧[1] 吕树铮[1] 李志忠[1] 陈方[1] 周玉杰[1] 顾承雄[1] 黄方炯[1] 

机构地区：[1]首都医科大学附属北京安贞医院,北京100029

出　　处：《中国危重病急救医学》2007年第11期641-643,共3页Chinese Critical Care Medicine

基　　金：国家重点基础研究发展“973”规划项目基金资助项目（2003CB517103）

摘　　要：目的评价慢性贫血对冠心病患者血运重建术后院内临床结果的影响。方法选择2002年7月—2004年6月在首都医科大学附属北京安贞医院接受血运重建治疗（经皮冠状动脉介入治疗或冠状动脉旁路移植术）的3679例患者,按照世界卫生组织确定的贫血标准（血红蛋白：男性〈120g/L,女性〈110g/L）将患者分为贫血和非贫血两组。比较两组患者血运重建术后院内不良心脑血管事件（MACCE）的发生率（包括全因死亡、新发心肌梗死、卒中和再次血运重建）,并分析其可能的原因。结果3679例患者中有贫血患者426例（占11.6%）,非贫血患者3253例（占88.4%）。贫血组与非贫血组分别有10例（2.4%）和64例（1.9%）发生院内死亡（P〈0.05）;贫血组院内MACCE的发生率明显高于非贫血组（4.2%比3.2%,P〈0.05）,但两组新发心肌梗死（0.7%比0.6%）、卒中（1.2%比0.4%）和再次血运重建（0比0.2%）的发生率差异无统计学意义（P均〉0.05）。结论合并贫血的冠心病患者较非贫血患者血运重建术后院内MACCE发生率增加,其中全因病死率的增加更为显著。Objective To evaluate the in-hospital clinical outcome of revascularization in patients with coronary artery disease with chronic anemia. Methods Between July 2002 and June 2004, 3 679 patients in Anzhen Hospital Affiliated to Capital University of Medical Sciences were subjected to revascularization percutaneous coronary intervention （PCI） or coronary artery bypass graft（CABG） during hospitalization. These patients were divided into anemia group and non-anemia group according to blood hemoglobin （Hb） level World Health Organization （WHO） standard （male〈120 g/L,female〈110 g/L） as anemia. Rates of in-hospital main adverse cardiac and cerebral events （MACCE）, including all-cause death, new attack of myocardial infarction, stroke and repeated revascularization were compared between two groups. Results There were 426 anemia patients （11.6%） and 3 253 non-anemia patients （88.4%）. In-hospital death in the anemia group was higher than that of the non-anemia group 10 cases （2.4%） vs. 64 cases （1.9%）, P〈0.05. Rates of MACCE of the anemia group was higher than that of the non-anemia group （4.2% vs. 3.2%, P〈0.05）. There was no significant difference in rates of new attack of myocardial infarction （0.7% vs. 0.6%）, stroke （1.2% vs. 0.4%） and repeated revascularization （0 vs. 0.2%） between two groups （all P〉0.05）. Conclusion Compared with non-anemia patients, anemia patients with coronary artery disease has higher in-hospital MACCE rate and all-cause mortality.

关 键 词：贫血 慢性 经皮冠状动脉介入治疗 冠状动脉旁路移植术 血运重建 

分 类 号：R686[医药卫生—骨科学]