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贫血患者血红蛋白水平与心电图(ECG)表现的相关性:一项横断面研究。

Correlation Between Haemoglobin Level and Electrocardiographic (ECG) Findings in Anaemia: A Cross-Sectional Study.

作者信息

Gv Shashikala, Pk Shashidhar, Herur Anita, Chinagudi Surekharani, Patil Shailaja S, Ankad Roopa B, Badami Sukanya V

机构信息

Assistant Professor, Department of Physiology, S. Nijalingappa Medical College and HSK Hospital , Bagalkot, India .

Assistant Professor, Department of Medicine, S. Nijalingappa Medical College and HSK Hospital , Bagalkot, India .

出版信息

J Clin Diagn Res. 2014 Apr;8(4):BC04-6. doi: 10.7860/JCDR/2014/8966.4202. Epub 2014 Mar 28.

Abstract

BACKGROUND

Anaemia affects the body by decreased oxygen (O2) carrying capacity of the blood. There is growing evidence that anaemia contributes to cardiac disease and death. It causes O2 supply - demand myocardial mismatch causing myocardial ischemia. There is diversity of opinion available in literature on reports of electrocardiographic (ECG) changes in anaemia.

AIM

To study the ECG changes in anemic population and to correlate ECG changes seen with increasing severity of anaemia.

MATERIALS AND METHODS

In hundred anemic adults, haemoglobin level and resting ECG were recorded. They were grouped according to haemoglobin level. ECG findings and varying severity of haemoglobin (Hb) level of each group were correlated using Pearson 's co-relation co-efficient and association was calculated using Chi-square test.

RESULTS

ECG changes in patients with Hb level of 0-5gm% showed ST segment depression in 50-75%, T wave changes in 29-50% and Left Ventricular Hypertrophy (LVH) in 25-30% of patients. Less percentage of patients with 5-7gm% Hb showed such changes, and patients with 7-8gm% Hb, showed no changes. As the Hb level decreased there was more percentage of patients having tachycardia and ECG changes. There was a strong negative correlation between Hb level and tachycardia and ECG changes.

CONCLUSION

Diagnosing anaemia in critical care can be supported by ECG changes like ST depression, T wave changes, with/without associated QRS abnormalities to avoid misdiagnosis and also as dramatic clinical and ECG recovery can be achieved with anaemia correction.

摘要

背景

贫血通过降低血液的氧(O₂)携带能力来影响身体。越来越多的证据表明贫血会导致心脏病和死亡。它会导致氧供需心肌不匹配,从而引起心肌缺血。关于贫血时心电图(ECG)变化的报道,文献中有多种观点。

目的

研究贫血人群的心电图变化,并将观察到的心电图变化与贫血严重程度的增加相关联。

材料与方法

记录了100名贫血成年人的血红蛋白水平和静息心电图。他们根据血红蛋白水平进行分组。使用Pearson相关系数对每组的心电图表现和血红蛋白(Hb)水平的不同严重程度进行相关性分析,并使用卡方检验计算关联性。

结果

血红蛋白水平为0 - 5gm%的患者中,50 - 75%出现ST段压低,29 - 50%出现T波改变,25 - 30%出现左心室肥厚(LVH)。血红蛋白水平为5 - 7gm%的患者出现此类变化的比例较低,而血红蛋白水平为7 - 8gm%的患者未出现变化。随着血红蛋白水平降低,出现心动过速和心电图改变的患者比例增加。血红蛋白水平与心动过速和心电图改变之间存在强烈的负相关。

结论

在重症监护中,心电图变化如ST段压低、T波改变,伴或不伴有相关QRS异常,可辅助诊断贫血,以避免误诊,而且纠正贫血后临床和心电图可实现显著恢复。

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