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目的:探讨贫血对急性冠状动脉(冠脉)综合征患者主要不良心血管事件的影响。方法:纳入行冠脉造影术的急性冠脉综合征患者428例,测定血红蛋白水平并进行临床随访;据血红蛋白水平分为贫血组和非贫血组,随访终点为心源性死亡、脑卒中、心力衰竭、非致死性心肌梗死以及因心绞痛再入院。建立Cox相对风险比例回归模型分析危险因素与终点事件间的关系,采用Kaplan-Meier法比较2组间生存率的差异。结果:贫血组的血红蛋白水平为107.5(81～120)g/L,非贫血组为136.0(111～178)g/L,平均随访期为20(1～120)个月,随访结束时共104例达终点。Cox回归模型显示血红蛋白(RR=0.363,95%CI:0.171～0.770,P=0.008)与急性冠脉综合征预后相关,Kaplan-Meier分析显示贫血组30d(92.0%∶96.9%,P=0.018)、90d(86.8%∶92.4%,P=0.048)及随访结束时(42.2%∶53.6%,P=0.035)的无事件累积生存率均低于非贫血组。结论:血红蛋白水平是影响急性冠脉综合征患者预后的因素之一,贫血的急性冠脉综合征患者预后较差。
Objective: To investigate the effect of anemia on major adverse cardiovascular events in patients with acute coronary syndrome (ACS). Methods: 428 patients with acute coronary syndrome undergoing coronary angiography were enrolled in the study. The hemoglobin levels were measured and followed up clinically. According to the hemoglobin level, patients were divided into anemia group and non-anemia group. The follow-up end points were cardiogenic death, stroke, Failure, non-fatal myocardial infarction and re-admission due to angina. The Cox relative risk proportional regression model was established to analyze the relationship between risk factors and end points. The Kaplan-Meier method was used to compare the survival rates between the two groups. Results: The hemoglobin level was 107.5 (81-120) g / L in anemia group and 136.0 (111-178) g / L in non-anemia group. The average follow-up period was 20 (1- 120) months. At the end of follow-up, 104 Example of the end of the arrival. Cox regression model showed that the hemoglobin (RR = 0.363, 95% CI: 0.171-0.770, P = 0.008) was associated with the prognosis of acute coronary syndrome. Kaplan-Meier analysis showed that the anemia group had a significant difference between the two groups (92.0% vs 96.9%, P = 0.018) , 90d (86.8%: 92.4%, P = 0.048) and the end of follow-up (42.2%: 53.6%, P = 0.035) Conclusion: Hemoglobin level is one of the factors affecting the prognosis of patients with acute coronary syndrome. Anemia of acute coronary syndrome patients have poor prognosis.