血红蛋白水平对老年急性冠脉综合征患者近期预后的影响  

Influence of association of hemoglobin level with recent prognosis in the elderly patients with acute coronary syndrome

作　　者：向凝[1] 杨柳[1] 谢登海[1] 

机构地区：[1]贵阳医学院附属医院心血管内科,贵阳550004

出　　处：《贵州医药》2011年第5期412-414,共3页Guizhou Medical Journal

摘　　要：目的初步探讨不同血红蛋白水平及住院期间血红蛋白下降幅度与老年急性冠脉综合征(ACS)患者近期预后的关系。方法将188例≥60岁ACS住院患者根据血红蛋白(HB)水平分为A(HB适中组)、B(贫血组)、C(HB偏高组)三组,再根据住院后血红蛋白下降水平是否高于10 g/dL分为两个亚组,分析HB水平及其下降幅度对住院期间心脏不良事件的影响。结果 B组较A组住院期间再发心肌缺血、心功能恶化及心脏事件总发生率均明显增高(P<0.05);C组较A组再发心肌缺血和心脏不良事件总发生率也增高。B组中,B2亚组(d>10 g/dL)较B1亚组(d<10 g/dL)心脏事件发生率增高(P<0.05)。结论贫血及HB增高均可增加老年ACS患者住院期间心脏不良事件发生率,在贫血患者中住院期间HB水平下降>10 g/dL即可对近期预后产生不良影响。Objective To examine the relationship between different hemoglobin（HB） level and its decreases during admission and the recent prognosis for the elderly patients with acute coronary syndrome（ACS）.Methods The 188 elderly patients with ACS whose age is above 60 years old were divided into three groups according to the hemoglobin levels： group A（acceptable HB）,group B（anemia）,group C（increased HB）.Each group was divided into two subgroups according to the descrease 〈10 g/dL or 〉10 g/dL of HB levels to analyze the major adverse cardiovascular event by hemoglobin levels and decreases in the duration of hospital stay.Results The incidences of recurrent myocardial ischemia and aggravated heart failure and total adverse events in group B were higher than those in group A（22.8% VS 10.2%,24.6% VS 8.2%,64.3% VS 21.4）（〈P0.05）.The incidences of recurrent myocardial ischemia and total adverse events in group C were higher than those in group A（26.5% VS 10.2%,55.9% VS 21.4）（P〈0.05）.which were higher in the subgroup B when the hemoglobin〉 10 g/dL is compared to hemoglobin〈 10 g/dL（P〈0.05）.Conclusion The incidences of adverse events will be increased for the elderly patients with ACS during admission for the anemia group and increased HB group.It will have a bad effect for the worse recent prognosis when the slight descrease in HB（〉10 g/dL） for anemia patients with ACS during admission.

关 键 词：老年 血红蛋白 急性冠脉综合征 预后 

分 类 号：R543.3[医药卫生—心血管疾病]