CAJ | 학술논문

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。
목적：평개빈혈대노년급성관상동맥종합정（ACS）환자경피관상동맥개입치료（PCI）술후예후적영향。 　　방법：입선2010-06지2012-06접수단순PCI술적노년（년령>60세）ACS환자908례，근거세계위생조직대빈혈적정의（혈홍단백녀성<12.0 g/dl、남성<13.0 g/dl）장환자분위빈혈조（283례）화비빈혈조（625례），비교량조환자적림상특정。PCI술후대환자진행1년적수방，비교량조환자적병사솔화주요심뇌혈관불량사건（MACCE：포괄심원성사망、심기재경사、심공능악화、파혈관재차혈운중건、뇌출혈、뇌경사）적발생솔。 　　결과：31%적노년ACS환자환유빈혈。빈혈조적ACS환자고령、녀성、당뇨병、고혈압、만성신공능불전、사혈분수강저이급삼지혈관병변적비례명현고우비빈혈조（P<0.05）。PCI술후1년적병사솔화MACCE발생솔명현고우비빈혈조（P<0.05）。다인소회귀분석현시，빈혈시노년ACS환자PCI술후1년병사솔적일개독립예측인소（P<0.05）。 　　결론：빈혈가증가노년ACS환자PCI술후장기적총사망솔화MACCE。
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.