慢性心力衰竭合并贫血临床特征分析

Clinical characteristics of chronic heart failure with anemia and iron deficiency

摘要:

目的  通过回顾性研究慢性心力衰竭（CHF）患者合并贫血临床特征，探讨其临床价值。方法  将CHF合并贫血的患者作为观察组（68例），不合并贫血症状的患者为对照组（38例），并依据心功能分级为Ⅱ～Ⅳ级，分别比较两组患者心功能情况和临床症状，探究贫血与老年CHF严重程度之间的相关性。结果  在患者一般资料中，两组在左心室射血分数和左心室舒张末内径比较差异有统计学意义；两组贫血数据指标中，血红蛋白和贫血发生率以及铁缺乏发生率比较差异有统计学意义；血清铁蛋白水平在对照组与心功能Ⅳ组比较差异有统计学意义；血清铁水平在对照组分别与心功能Ⅱ级组、Ⅲ级组、Ⅳ级组之间以及在心功能Ⅱ级组与Ⅳ级组、心功能Ⅲ级组与Ⅳ级组之间比较差异有统计学意义；血红蛋白水平在对照组分别与心功能Ⅱ级组、Ⅲ级组、Ⅳ级组之间比较差异有统计学意义；患者贫血发生率对照组分别与心功能Ⅱ级组、Ⅲ级组、Ⅳ级组之间比较差异有统计学意义；患者铁缺乏发生率对照组分别与心功能Ⅲ级组、Ⅳ级组之间以及在心功能Ⅱ级组与Ⅲ级组之间比较差异有统计学意义；观察组中的贫血患者与非贫血患者在铁缺乏发生率、血清铁蛋白、血清铁比较差异有统计学意义。结论  贫血发生率、铁缺乏发生率在重度心力衰竭组的发生率明显高于轻、中度心力衰竭组，对于CHF铁缺乏患者，进行适当的铁剂补充，可以改善患者心功能症状。

Abstract:

Objective To investigate the clinical characteristics of chronic heart failure patients with anemia by retrospective study and discuss their clinical value. Methods The patients of chronic heart failure with anemia were marked as observation group (n = 68), those without anemia marked as control group (n = 38), and their cardiac function was classified into Ⅱ-Ⅳ. Cardiac function and clinical symptoms were compared between the two groups. The relationship between anemia and severity of chronic heart failure was investigated in elderly people. Results In the general information of the patients, the left ventricular ejection fraction and the left ventricular end diastolic diameter were significantly different between both groups. Comparing anemia data of the two groups, hemoglobin and the incidence of iron deficiency and anemia were significantly different. Serum ferritin level was significantly different between the control group and cardiac function Ⅳ group. The serum iron level was significantly different between the control group and the heart function Ⅱ, Ⅲ and Ⅳ groups, and between heart function Ⅳ group and heart function Ⅱ and Ⅲ groups. There were significant differences in the hemoglobin level and the incidence of anemia between the control group and the heart function Ⅱ, Ⅲ and Ⅳ groups. The iron-deficiency incidence was significantly different between the control group and the heart function Ⅲ and Ⅳ groups, and between the heart function Ⅱ group and the heart function Ⅲ group. In the observation group, the anemia patients and non-anemia patients had statistical differences in iron-deficiency occurrence rate, serum ferritin and serum iron. Conclusions The incidence of iron deficiency and anemia in the severe heart failure group is obviously higher than that of mild and moderate heart failure groups. To chronic heart failure patients with iron deficiency, proper complement of iron agent can improve cardiac function in patients with symptoms.