三级护理医院心内科重症监护病房收治的急性冠状动脉综合征患者的血红蛋白水平

Haemoglobin Levels in Acute Coronary Syndrome Patients Admitted in Cardiology Intensive Care Units in a Tertiary Care Hospital.

作者信息

Naqvil Syed Mujtaba Hussain, Rao T Ramesh Kumar, Chandra Shobha Jagdish

出版信息

J Assoc Physicians India. 2015 Jun;63(6):26-9.

Abstract

OBJECTIVE

Epidemiology of abnormal haemoglobin levels and its association with severity of coronary artery disease in Indian patients is uncertain. This prospective observational study was conducted to determine the haemoglobin levels in acute coronary syndrome (ACS) patients and the association of anaemia with the severity of coronary artery disease (CAD) on coronary angiography (CAG).

METHODS

The patients diagnosed with ACS (ST-elevated and non-elevated MI, unstable angina) based on ECG and cardiac enzymes and admitted in cardiology ICU were enrolled in the study after fulfilling study criteria and the baseline haemoglobin level was recorded. The severity of coronary disease of patients who underwent coronary angiography was recorded.

RESULTS

A total of 162 patients were enrolled for the study. The overall haemoglobin of patients was 11.99 ± 2.24 g/dl with 12.46 ± 2.33 g/dl in males and 11.17 ± 1.82 g/dl in females (p < 0.05). Anaemia was found in 62.96% patients with no significant gender difference (p > 0.05), however abnormal haemoglobin level (Hb > 16g/dl) was found exclusively in 7.7% males. One hundred one patients underwent coronary angiography and anaemia was present in 60 patients (58.82%) and absent in 41 (40.59%). The difference in mean haemoglobin levels in anaemic patients with single, double, and triple vessel disease was significant (p < 0.05) and corresponding levels in non-anaemic patients were insignificant (p > 0.05). A weak correlation was observed between the haemoglobin level of patients and the percentage of obstruction in CAG (r = 0.26). The odds of having triple vessel disease in anaemic patient are 1.77 (95% CI 0.71 to 4.43). However, the association between anaemia and the severity of coronary artery disease was statistically found to be non-significant.

CONCLUSION

The mean haemoglobin levels decreased as the severity of CAD increased in CAG, however the association was not established between anaemia and the severity of coronary artery disease statistically.

摘要

目的

印度患者中异常血红蛋白水平的流行病学及其与冠状动脉疾病严重程度的关联尚不确定。本前瞻性观察性研究旨在确定急性冠状动脉综合征（ACS）患者的血红蛋白水平，以及贫血与冠状动脉造影（CAG）显示的冠状动脉疾病（CAD）严重程度之间的关联。

方法

根据心电图和心脏酶诊断为ACS（ST段抬高型和非ST段抬高型心肌梗死、不稳定型心绞痛）并入住心内科重症监护病房的患者，在符合研究标准后纳入研究，并记录基线血红蛋白水平。记录接受冠状动脉造影患者的冠状动脉疾病严重程度。

结果

共有162例患者纳入本研究。患者的总体血红蛋白水平为11.99±2.24g/dl，男性为12.46±2.33g/dl，女性为11.17±1.82g/dl（p<0.05）。62.96%的患者存在贫血，无显著性别差异（p>0.05），然而仅7.7%的男性血红蛋白水平异常（Hb>16g/dl）。101例患者接受了冠状动脉造影，其中60例（58.82%）存在贫血，41例（40.59%）不存在贫血。单支、双支和三支血管病变的贫血患者平均血红蛋白水平差异有统计学意义（p<0.05），非贫血患者的相应水平差异无统计学意义（p>0.05）。观察到患者的血红蛋白水平与CAG中的阻塞百分比之间存在弱相关性（r=0.26）。贫血患者发生三支血管病变的几率为1.77（95%CI 0.71至4.43）。然而，贫血与冠状动脉疾病严重程度之间的关联在统计学上无显著意义。