摘要
目的探究铁缺乏对慢性心力衰竭(chronic heart failure,CHF)患者生活质量的影响及近期主要不良心血管事件(major adverse cardiac events,MACE)的预测价值。方法选取邢台市第三医院2017年1月至2019年10月168例CHF患者作为研究对象,根据是否伴有铁缺乏分为铁缺乏组(107例)、铁正常组(61例)。采用明尼苏达心力衰竭生活质量问卷调查表(Minnesota living with heart failure questionnaire,MLHFQ)评分评估对比两组生活质量,根据铁缺乏组MLHFQ评分平均值分为低生活质量亚组、高生活质量亚组,比较两组患者的临床资料、铁代谢指标[血清铁、铁蛋白(serum ferritin,SF)、转铁蛋白饱和度(transferrin saturation,TSAT)]。采用Pearson相关性评价铁代谢指标与MLHFQ评分相关性,并进行偏相关性分析。比较铁缺乏组不同预后患者铁代谢指标,并采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析铁代谢指标对患者近期MACE的预测价值。结果Pearson相关性分析结果显示,血清铁、SF、TSAT与MLHFQ评分呈负相关(r=-0.826、-0.820、-0.776,P均<0.05)。将年龄、左心室射血分数(left ventricular ejection fraction,LVEF)、心功能分级等其他因素控制后,血清铁(偏回归系数:-0.641)、SF(偏回归系数:-0.715)、TSAT(偏回归系数:-0.768)仍与MLHFQ评分显著相关(P<0.05)。随访3个月,铁缺乏组预后不良亚组患者血清铁浓度[(9.13±1.26)μmol/L vs.(10.62±1.41)μmol/L,P<0.05]、SF[(76.29±8.33)μg/L vs.(86.27±10.46)μg/L,P<0.05]、TSAT[(18.04±3.16)%vs.(21.65±3.57)%,P<0.05]低于预后良好亚组,差异有统计学意义。血清铁、SF、TSAT联合预测CHF患者近期MACE的曲线下面积为0.871,敏感度、特异度分别为86.67%、71.43%。结论铁缺乏可能降低CHF患者生活质量,早期联合检测血清铁、SF、TSAT等铁代谢指标水平,对CHF患者近期MACE发生风险具有一定预测价值。
Objectives To explore the influence of iron deficiency on the quality of life of patients with chronic heart failure(CHF)and its predictive value of recent major adverse cardiac events(MACE).Methods A total of 168 CHF patients in The Third Hospital of Xingtai City from January 2017 to October 2019 were selected as the research objects.According to whether they were accompanied by iron deficiency,they were divided into iron deficiency group(107 cases)and iron normal group(61 cases).The Minnesota living with heart failure questionnaire(MLHFQ)was used to evaluate and compare the quality of life of the two groups.According to the average value of the MLHFQ scores,patients in iron deficiency group were divided into low quality of life sub group and high quality of life subgroup.The clinical data,iron metabolism indexes[serum iron,serum ferritin(SF),transferrin saturation(TSAT)]of the two subgroups were com⁃pared.The correlations between iron metabolism indexes and MLHFQ score were evaluated by Pearson correlation.Partial correlation analysis was performed.The iron metabolism index levels of patients with different prognosis in iron deficiency group were compared.The receiver operating characteristic curve(ROC)was used to analyze the predictive value of iron metabolism indexes for the recent MACE.Results Pearson correlation analysis showed that serum iron,SF,TSAT negatively correlated with the MLHFQ score(r=-0.826,-0.820,-0.776,all P<0.05).After controlling for other factors such as age,left ventricular ejection fraction(LVEF),cardiac function classification,serum iron(partial regression coefficient:-0.641),SF(partial regression coefficient:-0.715),TSAT(partial regression coeffi⁃cient:-0.768)still significantly correlated with the MLHFQ score(P<0.05).After 3 months of follow-up,the serum concentration of iron[(9.13±1.26)μmol/L vs.(10.62±1.41)μmol/L,P<0.05],SF[(76.29±8.33)μg/L vs.(86.27±10.46)μg/L,P<0.05]and TSAT[(18.04±3.16)%vs.(21.65±3.57)%,P<0.05]of those with poor prognosis in iron deficiency group wer
作者
袁莹
齐素霞
王莹
刘莹
YUAN Ying;QI Su-xia;WANG Ying;LIU Ying(The Third Hospital of Xingtai City,Xingtai,Hebei 054000,China)
出处
《岭南心血管病杂志》
CAS
2021年第6期688-692,718,共6页
South China Journal of Cardiovascular Diseases
基金
邢台市科技项目:铁缺乏对慢性心衰患者生活质量的影响研究(项目编号:20191677)。
