贫血与老年急性冠状动脉综合征患者介入治疗后远期病死率的关系  

Impact of anemia on long-term outcome in elderly patients with acute coronary syndrome undergoing percutaneons coronary interventions

作　　者：池喆[1] 米树华[1] 张晓霞[1] 关杨[1] 赵全明[1] 吴学思[1] 

机构地区：[1]首都医科大学附属北京安贞医院特需医疗科,100029

出　　处：《中华心血管病杂志》2012年第11期920-923,共4页Chinese Journal of Cardiology

摘　　要：目的探讨经皮冠状动脉介入治疗（PCI）术前贫血与老年急性冠状动脉综合征患者术后远期病死率的关系。方法入选2005年7月至2007年9月接受单纯PCI、未接受溶栓治疗、无慢性肾功能不全病史、年龄／〉60岁、有术前血红蛋白值记录的急性冠状动脉综合征患者1014例进行回顾性分析。根据世界卫生组织的贫血诊断标准（血红蛋白男性〈130g／L，女性〈120g／L），将患者分为贫血组（253例）和非贫血组（761例）。分析两组患者的临床特点及贫血与术后远期病死率的关系。结果贫血组糖尿病的比例和血清肌酐水平高于非贫血组，而收缩压和低密度脂蛋白胆固醇水平低于非贫血组（P〈0．05或P〈0．01）。PCI术后随访528（178～675）d。多因素Cox回归分析显示，术前贫血是PCI术后死亡的独立预测因素（RR：3．293，95％CI：1．431～7．578，P〈0．01）。结论术前贫血是老年急性冠状动脉综合征患者PCI术后远期病死率的独立预测因素。Objective To assess the impact of pre-procedure anemia on the long-term mortality in elderly patients with acute coronary syndrome （ACS） after percutaneous coronary interventions. Methods A total of 1014 ACS patients （ ≥ 60 years of age） with hemoglobin data and without previous treatment with thrombolytic agents and without end-stage renal failure before the interventional procedure were included. Patients were classified as anemia using the definition of World Health Organization： hemoglobin 〈 130 g/L in men, and 〈 120 g/L in women. A total of 253 patients were anemia. The clinical features of patients with and without anemia and association of pre-procedure anemia with long-term mortality were analyzed. Results Incidence of diabetes and serum creatinine level were significantly higher in anemia patients than in non-anemia patients while systolic blood pressure and low-density lipoprotein cholesterol were significantly lower in anemia patients than in non-anemia patients（P 〈 0.05 or P 〈 0.01 ）. The patients were followed up for 528 （ 178 - 675 ） days. After adjustment for potential co-variants in Cox regression analysis, pre-procedure anemia was associated with a significantly higher long-term mortality （RR ：3. 293, 95% CI： 1. 431 - 7. 578, P 〈 0. 01 ）. Conclusion Pre-procedure anemia is an independent predictor of long-term mortality in elderly patients with acute coronary syndrome after percutaneous coronary interventions.

关 键 词：贫血 血管成形术 经腔 经皮冠状动脉 预后 

分 类 号：R541.4[医药卫生—心血管疾病]