贫血和慢性肾脏病对住院充血性心力衰竭患者的影响

目的探讨贫血和慢性肾脏病(CKD)在住院充血性心力衰竭(CHF)患者中的发生情况以及对住院期间患者预后的影响。方法回顾性分析183例NYHA心功能分级为Ⅱ级至Ⅳ级的CHF住院患者,将患者分为4组:贫血组、非贫血组、CKD组、非CKD组。统计贫血和CKD发生率,比较患者采用NYHA心功能分级确定的心力衰竭严重程度,分析贫血和CKD是否与患者住院期间的死亡有关及影响贫血的因素。结果37.7%的CHF患者发生贫血,55.74%的患者发生CKD;贫血和CKD均与NYHA心功能分级的严重程度相关,Ⅱ级、Ⅲ级和Ⅳ级合并贫血者分别为10.2%、38.9%和65.9%,合并CKD者分别为34.7%、53.3%和84.1%;随NYHA心功能分级增加,血色素(Hb)和估算的肌苷清除率(eGFR)水平明显下降(P<0.01);CKD和贫血与患者住院期间的死亡有相关性;贫血与CKD和NYHA心功能分级有相关性。结论贫血和CKD在充血性心力衰竭患者中比较普遍,CHF程度较重的患者容易存在贫血和CKD,贫血和CKD与住院CHF患者死亡有关,CKD可能是CHF患者发生贫血的主要原因之一。

The Impact of Anemia and Chronic Kidney Disease on Hospitalized Patients with Congestive Heart Failure

Objective To investigate the prevalence of anemia and chronic kidney diseases(CKD) in hospitalized patients with congestive heart failure(CHF) and their impact on outcome of these patients.Methods In a retrospective study we analyzed 183 patients admitted with the diagnosis of CHF, NYHA classes Ⅱto Ⅳ.Patients were divided into anemic and non-anemic groups or CKD and non-CKD groups according to the definition of anemia and CKD. The prevalence of anemia and CKD was determined. An analysis of the relationship between anemia or CKD and hospital mortality was conducted.Results The prevalence of anemia and CKD was 37.7% and 55.74% respectively. The severity of CHF was associated with anemia and CKD. From classes Ⅱto Ⅳ CHF, the prevalence was 10.2%, 38.9% and 65.9% respectively for anemia and 34.7%, 53.3% and 84.1% respectively for CKD. Marked reductions in the level of Hb and eGFR followed the advance of NYHA classes(P<0.01). There was a positive association between anemia, CKD and the hospital mortality. Anemia was associated with CKD and NYAH classes.Conclusion Anemia and CKD are common in patients with CHF. Patients with severe CHF are likely to have anemia and CKD. Anemia or CKD is associated with hospital death in patients with CHF. CKD is one of probable causes of anemia in CHF.