云南地区慢性心力衰竭患者合并贫血的流行病学调查

摘要

目的 回顾性研究慢性心力衰竭(CHF)患者贫血的发生率及相关影响因素.方法 连续筛选2452例出院诊断为CHF,纽约心脏病协会分级心功能处于Ⅱ~Ⅳ级的患者.分为CHF贫血组和非贫血组.调查并分析不同病因、性别、年龄、心功能、左心室射血分数(LVEF)组CHF患者合并贫血的发生率.结果 ①符合条件的2452例CHF患者中贫血发生率为11.83%,不同性别之间贫血发生率比较,差异有统计学意义(P<0.05),男性发生率高于女性.②各年龄组之间贫血发生率比较,差异有统计学意义(P<0.05),年轻老年组贫血发生率最高,其后依次是:中年组、长寿老年组、青年组;各病因之间贫血发生率比较,差异有统计学意义(P<0.05),冠状动脉粥样硬化性心脏(以下简称冠心病)病贫血发生率最高,其后依次是:风湿性心脏病、高原性心脏病;不同心功能级别组之间贫血发生率比较,差异有统计学意义(P<0.05),CHF患者心功能越差,贫血率越高.③LVEF保留的心力衰竭(HFpEF)和LVEF降低的心力衰竭合并贫血发生率分别为13.36%和9.80%,贫血更易见于HFpEF患者(P<0.05).结论 云南地区CHF患者合并贫血男性发生率高于女性;年轻老年组、冠心病引起CHF的患者贫血发生率最高;心功能越差,贫血发生率越高;贫血更易见于HFpEF患者.%Objective To explore the prevalence of anemia in patients with chronic heart failure (CHF) in Yunnan province. Methods The clinical data of 2,452 patients with CHF classed as grade II-IV by NYHA classification were collected. The age, genders, LVEFs, cardiac function of NYHA class and incidence of ane-mia were investigated in the CHF patients. Results Of the 2,452 CHF patients meeting the research condi-tions, the prevalence of anemia accounted for 11.83%, and the incidence in the male patients was significantly higher than that in the female patients (P<0.05). The prevalence of anemia was the highest in the young old group among different age groups, followed by middle-aged, older and young groups; the differences in the incidence of anemia among all age groups were statistically significant (P<0.05). The incidence of anemia was the highest in the patients with coronary heart disease, followed by those with rheumatic heart disease and hypertensive heart disease with significant differences among the groups (P<0.05). The incidence of ane-mia was significantly different among the groups of different cardiac function (P<0.05); the worse the cardiac function of the patients with CHF, the higher the anemia rate. The anemia prevalence of the HFpEF group and the HFrEF group was 13.36% and 9.80% respectively (P<0.05). Conclusions In Yunnan Province, the prevalence of anemia in male patients with CHF is higher than that in female patients. Moreover, the CHF accompanied with anemia is often associated with old age and coronary heart disease. The prevalence in-creases with the worsening of cardiac function. However, anemia is more common in HFpEF patients.