贫血对老年患者远期缺血性动脉血栓事件及死亡住院风险的预测  

Value of anemia in predicting risk of long-term ischemic atherothrombotic events and inhospital deaths in elderly patients

作　　者：李晓利 范利[3] 王强 曹剑[3] 吴建中 尹慧君 胡亦新[3] 刘霖[3] Li Xiaoli;Fan Li;Wang Qiang;Cao Jian;Wu Jianzhong;Yin Huijun;Hu Yixin;Liu Lin(Department of Geriatrics,Chinese PLA 309 Hospital,Beijing 100091,China)

机构地区：[1]解放军第三〇九医院干部病房,北京100091 [2]解放军第三〇九医院移植中心,北京100091 [3]解放军总医院南楼临床部

出　　处：《中华老年心脑血管病杂志》2018年第9期919-922,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81300252)

摘　　要：目的探讨贫血对老年患者远期缺血性心血管事件及死亡住院风险的预测价值。方法收集2008年4月~2010年7月北京地区部队干休所年龄≥60岁的离退休干部及其家属663例,根据国际卫生组织WHO贫血诊断标准分为贫血组91例与非贫血组572例,随访截止至2014年12月31日,观察终点事件,包括随访期首次因急性缺血性动脉血栓性(心肌梗死、缺血性脑卒中、不稳定性心绞痛和短暂性脑缺血发作)及全因死亡住院的事件及时间。结果随访4.4~6.7(5.5±0.9)年,205例患者发生终点事件,发生率30.9%。贫血组终点事件发生率明显高于对照组(52.7%vs 27.4%,P<0.01)。Kaplan-Meier生存曲线分析显示,贫血组终点事件发生率是非贫血组的2.10倍(95%CI:1.39~3.17,P<0.01)。经多因素校正后,贫血组终点事件发生率是非贫血组的1.64倍(95%CI:1.15~2.35,P<0.01)。结论贫血是老年患者远期因动脉血栓事件及全因死亡住院风险独立的预测因子。Objective To study the value of anemia in predicting the risk of long-term ischemic atherothrombotic events and inhospital deaths in elderly patients.Methods Six hundred and sixty-three≥60 years old retired veteran military officiers in Beijing district were divided into anemia group（n=91）and anemia-free group（n=572）according to the WHO diagnostic criteria for anemia.The patients were followed up for 4.4-6.7 years,during which the ischemic atherothrombotic endpoint events were recorded,including myocardial infarction,stroke,unstable angina pectoris,transient ischemic attack,all-cause deaths and their ocurrence time.Results The ischemic atherothrombotic endpoint events occurred in 205 patients during the 4.4-6.7（5.5±0.9）years follow-up period with an incidence of 30.9%.The incidence of ischemic atherothrombotic endpoint events was significantly higher in anemia group than in anemia-free group（52.7% vs27.4%,P〈0.01）.Kaplan-Meier survival curve analysis showed that the incidence of ischemic atherothrombotic endpoint events was 2.10-fold higher in anemia group than in anemia-free group and was 1.64-fold higher in anemia group than in anemia-free group after adjustment for multiple factors（P〈0.01）.Conclusion Anemia is an independent risk factor for long-term ischemic atherothrombotic events and all-cause inhospital deaths in elderly patients.

关 键 词：贫血 心肌缺血 心肌梗死 卒中 心绞痛 不稳定型 

分 类 号：R556[医药卫生—血液循环系统疾病] R54[医药卫生—内科学]