摘要
目的探讨血红蛋白(Hemoglobin,Hb)、促红细胞生成素(Erythropoietin,EPO)、转铁蛋白饱和度(Transferrin Saturation,TSAT)与冠心病(Coronary Heart Disease,CHD)心力衰竭患者并发主要心血管不良事件(Major Adverse Cardiovascular Events,MACE)的相关性。方法选取2019年8月至2022年8月我院收治的150例CHD心力衰竭患者为研究对象,随访6个月,根据是否并发MACE将患者分为MACE组(38例)和非MACE组(112例)。比较不同病变程度、不同纽约心脏协会心功能(New York Heart Association cardiac function,NYHA)分级患者入院时Hb、EPO、TSAT水平,比较两组(入院时、治疗2周后)各指标水平,分析入院时各指标水平与冠状动脉狭窄程度及NYHA分级相关性,采用接受者操作特性(Receiver Operating Characteristic,ROC)曲线分析其对CHD心力衰竭患者并发MACE的预测价值。结果不同病变程度患者入院时Hb、EPO水平比较:重度病变>中度病变>轻度病变,TSAT水平比较:重度病变<中度病变<轻度病变(P<0.05);不同NYHA患者入院时Hb、EPO水平比较:Ⅳ级>Ⅲ级>Ⅱ级>Ⅰ级,TSAT水平比较:Ⅳ级<Ⅲ级<Ⅱ级<Ⅰ级(P<0.05);治疗2周后MACE组Hb、EPO水平高于非MACE组,TSAT水平低于非MACE组,且非MACE组治疗两周后Hb、EPO水平下降,TSAT水平升高(P<0.05);治疗2周后Hb、EPO水平与冠状动脉狭窄程度、NYHA分级均呈正相关,TSAT水平与之均呈负相关(P<0.05);治疗2周后Hb、EPO、TSAT水平联合预测CHD心力衰竭患者并发MACE的曲线下面积(Area Under Curve,AUC)为0.930。结论血清Hb、EPO、TSAT水平与CHD心力衰竭病变程度、NYHA分级及是否并发MACE有紧密联系,其联合检测可为临床判断病情严重程度、预测是否并发MACE提供可靠参考。
Objective To explore the correlation between hemoglobin(Hb),erythropoietin(EPO),transferrin saturation(TSAT)and major adverse cardiovascular events(MACE)in patients with coronary heart disease(CHD)complicated by heart failure.Methods A total of 150 patients with CHD heart failure admitted to our hospital from August 2019 to August 2022 were selected for the study.The patients were divided into the MACE group(38 cases)and the non-MACE group(112 cases)based on the occurrence of MACE.The levels of Hb,EPO,and TSAT at admission were compared among patients with different degrees of disease and different New York Heart Association cardiac function(NYHA)classifications.The levels of each index in the two groups(at admission and after 2 weeks of treatment)were compared,and the correlation between the levels of each index at admission and the degree of coronary artery stenosis and NYHA classification was analyzed.The Receiver Operating Characteristic(ROC)curve was used to analyze its predictive value for MACE in patients with CHD heart failure.Results Comparison of Hb and EPO levels in patients with different degrees of disease on admission:severe>moderate>mild,TSAT level comparison:severe<moderate<mild(P<0.05);Similarly,Hb and EPO levels were higher in patients with more advanced NYHA classifications:class IV>class III>class II>class I,and TSAT levels were lower:class IV<class III<class II<class I(P<0.05);After 2 weeks of treatment,the Hb and EPO levels in the MACE group were higher than those in the non-MACE group,and the TSAT level was lower,the Hb and EPO levels in the non-MACE group decreased and the TSAT level increased(P<0.05);After 2 weeks of treatment,the Hb and EPO levels were positively correlated with the degree of coronary artery stenosis and NYHA classification,and the TSAT level was negatively correlated(P<0.05);The combined predictive value of Hb,EPO,and TSAT levels for MACE,as indicated by the area under the ROC curve(AUC),was 0.930.Conclusion Serum levels of Hb,EPO and TSAT are closely related to the sev
作者
张亚利
李小静
李龙
ZHANG Ya-li(Pingdingshan First People’s Hospital,Pingdingshan 467000,Henan,China)
出处
《牡丹江医学院学报》
2024年第5期90-93,157,共5页
Journal of Mudanjiang Medical University
