贫血对老年急性冠状动脉综合征患者经皮冠状动脉介入治疗术后预后的影响

摘要

目的：评价贫血对老年急性冠状动脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）术后预后的影响。　　方法：入选2010-06至2012-06接受单纯PCI术的老年（年龄>60岁）ACS患者908例，根据世界卫生组织对贫血的定义（血红蛋白女性<12.0 g/dl、男性<13.0 g/dl）将患者分为贫血组（283例）和非贫血组（625例），比较两组患者的临床特征。PCI术后对患者进行1年的随访，比较两组患者的病死率和主要心脑血管不良事件（MACCE：包括心原性死亡、心肌再梗死、心功能恶化、靶血管再次血运重建、脑出血、脑梗死）的发生率。　　结果：31%的老年ACS患者患有贫血。贫血组的ACS患者高龄、女性、糖尿病、高血压、慢性肾功能不全、射血分数降低以及三支血管病变的比例明显高于非贫血组（P<0.05）。PCI术后1年的病死率和MACCE发生率明显高于非贫血组（P<0.05）。多因素回归分析显示，贫血是老年ACS患者PCI术后1年病死率的一个独立预测因素（P<0.05）。　　结论：贫血可增加老年ACS患者PCI术后长期的总死亡率和MACCE。%Objective: To evaluate the impact of anemia on prognosis of elder patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods: A total of 908 consecutive ACS patients elder than 60 years of age with PCI in our hospital from 2010-06 to 2012-06 were studied. According to WHO deifnition of anemia (HB<12.0 g/dL in female and HB<13.0 g/dL in male), the patients were classiifed as Anemia group, n=283 and Non-anemia group, n=625. The patients were followed-up for 1 year. The basic clinical characteristics, incidences of mortality and major adverse cardiovascular and cerebravascular events (MACCE) were compared between 2 groups by cardiac death, myocardial re-infarction, worsening of cardiac function, target vessel revascularization, cerebral hemorrhage and cerebral infarction. Results: There were 31%of patients suffering from anemia. Anemia group had more patients with the elder age, female gender, diabetes, hypertension, chronic kidney disease, decreased LVEF, more patients with 3 vessel-disease, and higher mortality at 1 year after PCI, higher rate of MACCE than those in Non-anemia group, all P<0.05. Multiple regression analysis indicated that anemia is the independent predictor for mortality in elder ACS patients at 1 year after PCI, P<0.05. Conclusion: Anemia may increase the incidences of mortality and MACCE in elder ACS patients after PCI for a long-term.