Zeidman Aliza, Fradin Zinaida, Blecher Anetta, Oster Howard S, Avrahami Yoav, Mittelman Moshe
Department of Medicine B, Rabin Medical Center (Golda-Hasharon Campus), Petah Tiqva, Israel.
Isr Med Assoc J. 2004 Jan;6(1):16-8.
Anemia is a known risk factor for ischemic heart disease. Based on knowledge of the physiologic role of oxygen delivery to the myocardium, anemia may be a cause of more severe cardiovascular diseases or a marker of other processes occurring in the body that induce more severe disease.
To investigate the relationship between anemia and the clinical picture of IHD, including manifestations, severity and complications.
The population studied comprised 417 similarly aged patients with IHD and anemia. The patients were categorized into subgroups of IHD according to disease severity: namely, angina pectoris, acute ischemia, acute myocardial infarction, congestive heart failure or cardiac arrhythmias. Two populations served as control groups: patients with anemia but no IHD (C-I) and patients with IHD without anemia (C-II). A standard anemia workup was conducted in all patients with IHD and anemia and a correlation was made between the hematologic parameters and the manifestations and complications of IHD.
The common presenting symptom was chest pain in the study group and in C-II (94% and 86% respectively) and weakness (90%) in C-I. Patients with IHD and anemia tended to suffer from a more advanced degree of IHD (80%) compared to patients with IHD alone who had milder disease (46%). Hematologic values including hemoglobin, mean cell volume, serum iron and total iron-binding capacity correlated inversely with disease severity among anemic patients with IHD. There were significant differences between the study group and C-II regarding CHF (31% and 18% respectively) and arrhythmias (41% and 16% respectively). The mortality rate was higher in patients with IHD and anemia than in patients with IHD alone (13% and 4% respectively).
Anemia is a significant risk factor in IHD. It correlates with advanced IHD, CHF, rhythm disturbance and higher mortality rate. An aggressive therapeutic and preventive approach might improve the outcome of this disease.
贫血是缺血性心脏病已知的危险因素。基于对心肌氧输送生理作用的认识，贫血可能是更严重心血管疾病的病因，或是体内发生的导致更严重疾病的其他过程的标志物。
研究贫血与缺血性心脏病临床表现之间的关系，包括症状、严重程度和并发症。
研究人群包括417名年龄相近的缺血性心脏病合并贫血患者。根据疾病严重程度将患者分为缺血性心脏病亚组：即心绞痛、急性缺血、急性心肌梗死、充血性心力衰竭或心律失常。两个群体作为对照组：贫血但无缺血性心脏病的患者（C-I）和有缺血性心脏病但无贫血的患者（C-II）。对所有缺血性心脏病合并贫血患者进行标准的贫血检查，并对血液学参数与缺血性心脏病的表现和并发症进行相关性分析。
研究组和C-II组的常见症状是胸痛（分别为94%和86%），C-I组为虚弱（90%）。与单独患有缺血性心脏病且病情较轻的患者（46%）相比，缺血性心脏病合并贫血的患者往往患有更晚期的缺血性心脏病（80%）。在缺血性心脏病合并贫血的患者中，包括血红蛋白、平均红细胞体积、血清铁和总铁结合力在内的血液学值与疾病严重程度呈负相关。研究组与C-II组在充血性心力衰竭（分别为31%和18%）和心律失常（分别为41%和16%）方面存在显著差异。缺血性心脏病合并贫血患者的死亡率高于单独患有缺血性心脏病的患者（分别为13%和4%）。
贫血是缺血性心脏病的重要危险因素。它与晚期缺血性心脏病、充血性心力衰竭、节律紊乱和较高的死亡率相关。积极的治疗和预防方法可能会改善这种疾病的预后。
