贫血状态与冠心病患者左心室舒张功能的相关性  

Correlation of anemia status and left ventricular diastolic function in patients with coronary heart disease

作　　者：徐世莹 叶芳[2] 皮林 胡江乔 富丽娟 张明明[1] XU Shiying;YE Fang;PI Lin;HU Jiangqiao;FU Lijuan;ZHANG Mingming(Department of Cardiology,Chuiyangliu Hospital Affiliated to Tsinghua University,Beijing 100022,China;Department of Hematology,Chuiyangliu Hospital Affiliated to Tsinghua University,Beijing 100022,China)

机构地区：[1]清华大学附属垂杨柳医院心内科,北京100022 [2]清华大学附属垂杨柳医院血液科,北京100022

出　　处：《中国医药导报》2019年第22期87-89,97,共4页China Medical Herald

基　　金：首都卫生发展科研专项项目(首发2016-3-7031);北京市朝阳区科技计划项目(CYSF1812)

摘　　要：目的探讨贫血状态与冠心病患者左心室舒张功能的相关性。方法回顾性分析清华大学附属垂杨柳医院心内科2017年1月~2018年4月收治的冠心病患者282例的临床资料,根据有无贫血分为两组,其中无贫血患者共186例,设为A组,合并轻度贫血患者共96例,设为B组。比较两组年龄、血压、体重指数(BMI)、总胆固醇(TC)、糖化血红蛋白(HbA1c)、A峰、早期充盈E峰与晚期充盈A峰比值(E/A)、左室舒张末期内径(LVEDD)、左室后壁厚度(LVPWT)及合并疾病比例,并对血红蛋白水平与相关临床指标进行多元线性回归分析。结果B组BMI、TC、E/A及舒张压水平均显著低于A组,差异均有统计学意义(P<0.05);同时B组年龄、HbAlc、A峰、LVEDD及LVPWT水平均显著高于A组,差异均有统计学意义(P<0.05);两组原发性高血压发生率比较差异无统计学意义(P>0.05);B组糖尿病和舒张性心力衰竭发生率均显著高于A组(P<0.05)。多元线性回归分析结果显示,血红蛋白水平与年龄呈负相关(β=0.337),与E/A呈正相关(β=0.442),差异均有统计学意义(P<0.05)。结论冠心病患者贫血状态可影响左心室舒张功能,故在临床治疗过程中应重视纠正贫血,进而保护心脏功能。Objective To investigate the correlation of anemia status and left ventricular diastolic function in patients with coronary heart disease.Methods The clinical data of 282 patients with coronary heart disease admitted to Department of Cardiology of Chuiyangliu Hospital Affiliated to Tsinghua University from January 2017 to April 2018 was analyzed retrospectively.According to whether there were anemia,the patients were divided into two groups,total 186 cases of patients without anemia were set as group A,total 96 cases of patients with anemia were set as group B.The age,blood pressure,body mass index (BMI),total cholesterol (TC),glycosylated hemoglobin (HbA1c),A peak,E/A,left ventricular end diastolic diameter (LVEDD),left ventricular posterior wall thickness (LVPWT) and the proportion of complications of the two groups were compared,and the hemoglobin level and related clinical indicators were analyzed by multivariate linear regression analysis.Results The levels of BMI,TC,E/A and diastolic blood pressure of group B were lower than those of group A,the differences were statistically significant (P < 0.05).The levels of age,HbAlc,peak A value,LVEDD and LVPWT of group B were significantly higher than those of group A,the differences were statistically significant (P < 0.05).There was no significant difference in the incidence of primary hypertension between the two groups (P > 0.05).The incidence of diabetes and diastolic heart failure of group B was significantly higher than those of group A (P < 0.05).Multivariate linear regression analysis showed that hemoglobin level was negatively correlated with age (β= 0.337) and positively correlated with E/A (β= 0.442),the differences were statistically significant (P < 0.05).Conclusion The anemia status of patients with coronary heart disease can affect the left ventricular diastolic function.Therefore,it is necessary to pay attention to the correction of anemia in the course of clinical treatment,so as to protect cardiac function.

关 键 词：贫血 冠心病 左心室舒张功能 相关性 

分 类 号：R541.4[医药卫生—心血管疾病] R556.3[医药卫生—内科学]