急性心肌梗死合并贫血的临床特点与预后

目的研究急性心肌梗死（AMI）合并贫血的临床特点，并探讨其早期防治的意义。方法对162例AMI患者，据入院时血红蛋白（Hb）水平分为贫血组56例（轻度32例，中度18例，重度6例），非贫血组106例，比较两组的相关临床特点及预后指标。结果AMI合并贫血组的患者既往心绞痛史、ST段抬高心肌梗死（STEMI）的比例及肌酸磷激酶-同工酶（CK—MB）峰值显著高于非贫血组（P〈0．05），Hb水平、射血分数（LVEF）显著低于非贫血组（P〈0．01）。AMI合并贫血组的患者发生快速心律失常、killipⅡ以上泵衰竭、梗死后心绞痛的比例及住院病死率均显著高于非贫血组（P〈0．05）。贫血组住院期间重要临床事件亚组分析：killipⅡ以上泵衰竭、梗死后心绞痛、住院病死率随贫血程度增加而升高（P〈0．05）。结论AMI合并贫血的高危患者多，急性期重要临床事件发生率高，早期积极预防及纠正贫血可能对改善预后有积极的作用。

Clinical features and prognosis of AMI with anemia

Objectives To study the clinical features and prognosis of acute myocardial infarction （AMI） with anemia, and study the significance of early prevention and treatment. Method 162 patients with AMI were divided into 2 groups according to the hemoglobin （Hb） level. There were 56 cases in the anemia group （38 mild cases, 18 moderate cases and 6 severe） and 106 cases in the non-anemia group. The clinical features and prognoses of the two groups were compared. Results The history of angina, the percentage of ST-elevation myocardial infarction （STEMI）, and the value of phosphorus creatine kinase - isozymes （CK-MB） peak were significantly higher in AMI patients with anemia group than that in the non-anemia group （P〈0. 05）. Hb level and the left ventrieular ejection fraction （LVEF） in AMI with anemia group were significantly lower than those in the non-anemia group（P〈0.01）. The incidences of tachyarrhythmias, heart failure over killip grade II , post-MI angina and in-hospital death were significantly higher in AMI with anemia group than those in the non-anemia group （P 〈0.05）. The subgroup analysis of AMI with anemia group showed that heart failure over killip grade II , post-MI angina and in-hospital death increased with the degree of anemia（P〈0. 05）. Conclusion AMI with anemia group always accompanied with severe clinical features and a higher clinical adverse events. Early prevention and correction of anemia may improve the prognosis of AMI.