2022 年第 10 期 第 17 卷

不同程度心力衰竭合并贫血患者的病因及合并疾病特点分析

Etiology of patients with different degrees of heart failure complicated with anemia and characteristics of complications

作者：高杰1冯妍1王以新1陈婉萍1卢淑立2靳相公2曲星2

英文作者：Gao Jie1 Feng Yan1 Wang Yixin1 Chen Wanping1 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 Medicine 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：心力衰竭；贫血；影响因素；病因

英文关键词：Heartfailure;Anemia;Influencingfactors;Etiology

• 摘要：

• 目的 探讨不同程度心力衰竭合并贫血患者的病因及合并疾病特点。方法 选取首都医科大学附属北京安贞医院2018年1月至2020年12月收治的2 180例心力衰竭合并贫血患者。根据纽约心脏病协会心功能分级将患者分为轻度心力衰竭组（Ⅰ～Ⅱ级，999例）和重度心力衰竭组（Ⅲ～Ⅳ级，1 181例）。记录患者年龄、性别、合并疾病及引起心力衰竭的主要病因。采用二元Logistic回归模型分析心力衰竭合并贫血患者发展为重度心力衰竭的危险因素。结果 二元Logistic回归分析结果显示年龄≥60岁（比值比=2.210，95%置信区间：1.826~2.675）、肺部感染（比值比=2.318，95%置信区间：1.717~3.111）、肾脏病（比值比=1.646，95%置信区间：1.312~2.065）、消化道出血（比值比=1.620，95%置信区间：1.044~2.515）、原发性心肌病（比值比=4.665，95%置信区间：2.504~8.694）是心力衰竭合并贫血患者发展为重度心力衰竭的危险因素（均P＜0.05）。结论 年龄≥60岁、肺部感染、肾脏病、消化道出血以及原发性心肌病是心力衰竭合并贫血患者发展为重度心力衰竭的危险因素。

• Objective To investigate the etiology of patients with different degrees of heart failure complicated with anemia and characteristics of complications. Methods A total of 2 180 inpatients with heart failure complicated with anemia admitted to Beijing Anzhen Hospital, Capital Medical University from January 2018 to December 2020 were selected. According to New York Heart Assosiation cardiac function classification, patients were divided into mild heart failure group (grade Ⅰ-Ⅱ, 999 cases) and severe heart failure group (grade Ⅲ-Ⅳ, 1 181 cases). The age, gender, complications and the main cause of heart failure were recorded. Binary Logistic regression model was used to analyze the risk factors of severe heart failure in patients with heart failure complicated with anemia. Results Binary Logistic regression analysis showed that age ≥60 years ［odds ratio (OR)=2.210, 95% confidence interval(CI):1.826-2.675］, pulmonary infection(OR=2.318, 95%CI:1.717-3.111), kidney disease (OR=1.646, 95%CI:1.312-2.065), gastrointestinal bleeding (OR=1.620, 95%CI:1.044-2.515) and primary cardiomyopathy (OR=4.665, 95%CI:2.504-8.694) were risk factors of severe heart failure in patients with heart failure complicated with anemia (all P<0.05). Conclusion The age ≥60 years, pulmonary infection, kidney disease, gastrointestinal bleeding, and primary cardiomyopathy are risk factors of severe heart failure in patients with heart failure complicated with anemia.