CAJ | 학술논문

目的：探讨舒张性心力衰竭（DHF）患者血红蛋白（Hb）含量的变化，贫血与左室功能的关系及对预后的影响。方法：176例DHF患者按照NYHA分级分为：Ⅱ级78例，Ⅲ级50例，Ⅳ级48例，分析各组Hb水平和贫血患病率。按照贫血诊断标准患者被分为贫血组（58例，占33.0％）与非贫血组（118例，占67.0），对两组患者左室舒张功能，随访期间的死亡率及再住院率进行比较分析。结果：贫血组随心功能分级（Ⅱ级～Ⅳ级）增加， Hb水平呈下降趋势[（130±6） g／L比（108±4） g／L比（96±12） g／L]，而贫血的患病率逐渐增加（8.97％比36.0％比68.8％）， P均＜0.05。与非贫血组相比，贫血组的冠心病患者比例（55.1％比65.5％）、肌酐[（87.6±39.2）μmol／L比（113.7±59.8）μmol／L]、N 末端 B型利钠肽原[NT‐proBNP ，（578.0±136.7） pg／ml比（886.0±174.8） pg／ml]水平明显升高，舒张早期峰速减速时间明显增加[（137±15） ms比（196±13） ms]，二尖瓣舒张早期／晚期峰值流速比值[E／A ，（0.87±0.32）比（0.62±0.29）]明显减小（P均＜0.05）。随访期间与非贫血组比较，贫血组的死亡率（9.3％比20.7％）、再住院率（18.6％比32.8％）明显上升（ P均＜0.05）。结论：DHF患者常伴有贫血，随着心衰严重程度的加重其贫血发病率增加，贫血可能加重心脏舒张功能不全，合并贫血的DHF患者其死亡率及再住院率增加。
목적：탐토서장성심력쇠갈（DHF）환자혈홍단백（Hb）함량적변화，빈혈여좌실공능적관계급대예후적영향。방법：176례DHF환자안조NYHA분급분위：Ⅱ급78례，Ⅲ급50례，Ⅳ급48례，분석각조Hb수평화빈혈환병솔。안조빈혈진단표준환자피분위빈혈조（58례，점33.0％）여비빈혈조（118례，점67.0），대량조환자좌실서장공능，수방기간적사망솔급재주원솔진행비교분석。결과：빈혈조수심공능분급（Ⅱ급～Ⅳ급）증가， Hb수평정하강추세[（130±6） g／L비（108±4） g／L비（96±12） g／L]，이빈혈적환병솔축점증가（8.97％비36.0％비68.8％）， P균＜0.05。여비빈혈조상비，빈혈조적관심병환자비례（55.1％비65.5％）、기항[（87.6±39.2）μmol／L비（113.7±59.8）μmol／L]、N 말단 B형리납태원[NT‐proBNP ，（578.0±136.7） pg／ml비（886.0±174.8） pg／ml]수평명현승고，서장조기봉속감속시간명현증가[（137±15） ms비（196±13） ms]，이첨판서장조기／만기봉치류속비치[E／A ，（0.87±0.32） 비（0.62±0.29）]명현감소（P균＜0.05）。수방기간여비빈혈조비교，빈혈조적사망솔（9.3％비20.7％）、재주원솔（18.6％비32.8％） 명현상승（ P균＜0.05）。결론：DHF환자상반유빈혈，수착심쇠엄중정도적가중기빈혈발병솔증가，빈혈가능가중심장서장공능불전，합병빈혈적DHF환자기사망솔급재주원솔증가。
Objective:To explore change of hemoglobin (Hb) concentration ,the relationship between anemia and left ventricular function and the influence of anemia on prognosis in patients with diastolic heart failure (DHF ) . Methods :According to NYHA classification ,a total of 176 DHF patients were divided into class Ⅱ group (n=78) , class Ⅲ group (n=50) and class Ⅳ group (n=48) ,then Hb level and morbidity rate of anemia were analyzed in each group .According to diagnostic standard of anemia ,patients were divided into anemia group (n=58 ,occupied 33.0% ) and non anemia group (n=118 ,occupied 67.0% ) .Left ventricular diastolic function ,mortality rate and rehospitalization rate during follow‐up were compared and analyzed between two groups .Results:Along with cardi‐ac function class rose (from class Ⅱ to class Ⅳ) ,Hb level showed a decreasing trend [ (130 ± 6) g/L vs .(108 ± 4) g/L vs .(96 ± 12) g/L] ,while morbidity rate of anemia gradually rose (8.97% vs .36.0% vs .68.8% ) P<0.05 all in anemia group ;Compared with non‐anemia group ,there were significant rise in percentages of patients with coro‐nary heart disease (55.1% vs .65.5% ) ,levels of creatinine [ (87.6 ± 39.2)μmol/L vs .(113.7 ± 59.8)μmol/L] and N terminal pro B type natriuretic peptide [NT‐proBNP ,(578.0 ± 136.7) pg/ml vs .(886.0 ± 174.8) pg/ml] , and early‐diastolic peak velocity deceleration time [ (137 ± 15) ms vs .(196 ± 13) ms] ,and significant reduction in mitral early/late diastolic peak flow velocity [E/A ,(0.87 ± 0.32) vs .(0.62 ± 0.29)] , P<0.05 all .Compared with non‐anemia group , there were significant rise in mortality rate (9.3% vs .20.7% ) and rehospitalization rate (18.6%vs .32.8% ) in anemia group during follow‐up , P<0.05 all .Conclusion:DHF patients often complicate with anemia . Along with heart failure aggravates ,their morbidity rate of anemia rises ,and anemia may aggravate cardiac diastolic dysfunction .Mortality rate and rehospitalization rate rise in DHF patients complicated with anemia .