Hahn R G, Nilsson A, Farahmand B Y, Persson P G
Department of Anaesthesia, South Hospital, Stockholm, Sweden.
Eur Urol. 1997;31(2):199-203. doi: 10.1159/000474450.
To study risk factors for acute myocardial infarction (AMI) in men suffering from benign prostatic hypertrophy.
We followed 811 patients who underwent transurethral resection of the prostate (TURP) between 1983 and 1992 until the end of 1993 with regard to the incidence of AMI. The association between AMI and various potential risk factors was evaluated by epidemiological methods.
Fifty-two patients developed a first-time AMI after TURP. A pre-operative blood haemoglobin concentration in the range of 100-129 g/l (normal range 130-165 g/l) was associated with an increased long-term relative risk of a first-time AMI, which was estimated to be 2.0 (95% confidence interval = 1.0-4.1). This estimate became slightly stronger when we also included the 76 patients with a first AMI before surgery, 10 of whom developed a re-infarction after TURP. Furthermore, it was largely unchanged on adjusting for impaired health status and age > or = 75 years (patient factors) and for fluid absorption > or = 500 ml and a blood loss > or = 275 ml (operative factors), which had been reported to increase the long-term risk of AMI in a previous study.
A moderately reduced blood haemoglobin level before TURP is associated with a doubled risk of developing AMI in later life.
研究良性前列腺增生男性患者急性心肌梗死（AMI）的危险因素。
我们对1983年至1992年间接受经尿道前列腺切除术（TURP）的811例患者进行随访，直至1993年底，观察AMI的发生率。采用流行病学方法评估AMI与各种潜在危险因素之间的关联。
52例患者在TURP后首次发生AMI。术前血红蛋白浓度在100 - 129 g/l范围内（正常范围130 - 165 g/l）与首次AMI的长期相对风险增加相关，估计为2.0（95%置信区间 = 1.0 - 4.1）。当我们将术前首次发生AMI的76例患者也纳入分析时，这一估计值略有增强，其中10例患者在TURP后发生再梗死。此外，在对健康状况受损和年龄≥75岁（患者因素）以及液体吸收≥500 ml和失血≥275 ml（手术因素）进行校正后，该估计值基本未变，此前一项研究报告这些因素会增加AMI的长期风险。
TURP术前血红蛋白水平适度降低与晚年发生AMI的风险加倍相关。
