超高龄老年缺血性心脑血管病患者的血清铁水平

目的：观察年龄i〉90岁的超高龄缺血性心脑血管病（ICCVD）患者的血清铁水平及血清铁对该人群ICCVD发生率的诊断价值。方法：回顾性分析本院75例，≥90岁的超高龄ICCVD患者的临床资料及血清铁水平，取同期48例年龄≥90岁的超高龄无ICCVD病史者作对照组，比较ICCVD组及对照组血清铁水平，用ROC曲线，评价血清铁对ICCVD的诊断价值。结果：两组超高龄患者共123例的总血清铁浓度为（10．09±0．61）μmol／L，ICCVD组、对照组血清铁浓度分别为（11．50±5．85）和（7．67±6．40）μmol／L，组间差异有统计学意义（P〈0．01）。血清铁对CHD的诊断价值的ROC曲线下，面积为（0．64±0．06），有一定的诊断价值（P〈0．05），其中，当取血清铁浓度为10．30μmol／L时，诊断价值最高（敏感性0．51、特异性0．81、Youden指数为0．32）。结论：年龄≥90岁的超高龄ICCVD患者血清铁水平虽与非ICCVD患者组间有显著差异，但以血清铁水平来判断ICCVD发生率的诊断价值较低。

The Clinical Relevance of Serum Iron Level in Extremely Elder Patients with Ischemic Cardio-cerebrovascular Diseases

Objective：To determine the serum iron level in extremely elder patients （aged above 90 yrs） with ischemic cardio-cerebrovascular diseases （ICCVD） and to investigate its diagnostic value for ICCVD. Methods： The clinical data and serum iron level of 75 extremely elder patients with ICCVD （ICCVD group） admitted to our hospital were retrospectively analyzed. A contemporary cohort of 48 extremely elder patients without ICCVD （ control group） was also reviewed. The serum iron levels were compared between ICCVD group and control group. An ROC was used to evaluate the ICCVD-diagnostic value of serum iron levels. Results：Overall, the serum iron level was （ 10.09 ± 0.61 ）μmol/L in all 123 patients. The level of serum iron was （11.50± 5.85 ） μmol/L in the ICCVD group vs （7.67 ± 6.40 ）μmol/L in the control group ,with a significantly difference between the both（ P 〈0.01 ）. The AUC in ROC was （0.64 ± 0.06 ）, suggesting the value of serum iron level in diagnosis of ICCVD （ P 〈 0.05 ）. Best performance of diagnosis was achieved with cut-off value of serum iron level being 10.30μmol/L （ sensitivity = 0.51, specificity = 0. 81,Youden index = 0.32）. Conclusion：Despite significant difference between ICCVD group and non-ICCVD group of extremely elder patients, serum iron level may be of poor diagnostic value for ICCVD.