2022 年第 4 期 第 17 卷

心功能不全合并贫血患者发生急性心肌梗死的相关疾病因素研究

Study on the factors related to acute myocardial infarction in patients with cardiac insufficiency complicated with anemia

作者：高杰1冯妍1王以新2陈婉萍2卢淑立2靳相公2曲星2

英文作者：Gao Jie1 Feng Yan1 Wang Yixin2 Chen Wanping2 Lu Shuli2 Jin Xianggong2 Qu Xing2

单位：1首都医科大学附属北京安贞医院全科医疗科，北京100029；2首都医科大学全科医学与继续教育学院，北京100069

英文单位：1Department of General Medical Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2College of General Medicine and Continuing Education Capital Medical University Beijing 100069 China

关键词：心功能不全；贫血；急性心肌梗死；合并疾病

英文关键词：Cardiacinsufficiency;Anemia;Acutemyocardialinfarction;Combineddiseases

• 摘要：

• 目的 探讨心功能不全合并贫血患者发生急性心肌梗死的相关疾病因素。方法 选取2018年1月至2020年12月于首都医科大学附属北京安贞医院住院的心功能不全合并贫血患者3 040例，根据是否发生急性心肌梗死分为急性心肌梗死组（322例）和非急性心肌梗死组（2 718例）。比较2组患者年龄、性别、合并疾病等临床资料，分析患者发生急性心肌梗死的疾病因素。结果 急性心肌梗死组年龄、合并糖尿病、高血压、高脂血症、肾脏病、消化道出血比例均高于非急性心肌梗死组［（68±12）岁比（59±15）岁、53.1%（171/322）比24.5%（666/2 718）、70.5%（227/322）比53.5%（1 454/2 718）、59.6%（192/322）比26.0%（706/2 718）、58.7%（189/322）比30.1%（817/2 718）、15.2%（49/322）比5.5%（149/2 718）］，合并心房颤动、瓣膜病比例均低于非急性心肌梗死组［14.6%（47/322）比19.4%（527/2 718）、27.0%（87/322）比54.5%（1 480/2 718）］，差异均有统计学意义（均P＜0.10）。Logistic回归分析结果显示，年龄≥60岁、合并糖尿病、高脂血症、肾脏病、消化道出血是心功能不全合并贫血患者发生急性心肌梗死的独立危险因素（均P＜0.05）。结论 在心功能不全合并贫血患者中，年龄≥60岁患者合并有糖尿病、高脂血症、肾脏病、消化道出血时更容易发生急性心肌梗死。

• Objective To explore the characteristics of acute myocardial infarction in patients with cardiac insufficiency complicated with anemia. Methods Totally 3 040 patients with cardiac insufficiency complicated with anemia admitted to Beijing Anzhen Hospital, Capital Medical University from January 2018 to December 2020 were selected. According to whether acute myocardial infarction developed, patients were divided into acute myocardial infarction group (322 cases) and non acute myocardial infarction group (2 718 cases). The clinical data such as age, gender and combined diseases were compared between the two groups, and the influencing factors of acute myocardial infarction were analyzed. Results Age, the proportions of diabetes mellitus, hypertension, hyperlipidemia, kidney disease  and gastrointestinal bleeding in acute myocardial infarction group were higher than those in non acute myocardial infarction group［（68±12） years vs （59±15） years, 53.1%（171/322） vs 24.5%（666/2 718）, 70.5%（227/322） vs 53.5%（1 454/2 718）, 59.6%（192/322） vs 26.0%（706/2 718）, 58.7%（189/322） vs 30.1%（817/2 718）, 15.2%（49/322） vs 5.5%（149/2 718）］, the proportions of atrial fibrillation and valvular disease in acute myocardial infarction group were lower than those in non acute myocardial infarction group［14.6%（47/322） vs 19.4%（527/2 718）, 27.0%（87/322） vs 54.5%（1 480/2 718）］, and the differences were statistically significant (all P＜0.10). Logistic regression analysis showed that age ≥60 years, diabetes mellitus, hyperlipidemia, kidney disease and gastrointestinal bleeding were independent risk factors for acute myocardial infarction in patients with cardiac insufficiency complicated with anemia (all P＜0.05). Conclusion In patients with heart failure complicated with anemia, those age ≥60 years are more likely to develop acute myocardial infarction when they have diabetes mellitus, hyperlipidemia, kidney disease and gastrointestinal bleeding.