2021 年第 7 期 第 16 卷

血细胞比容与择期经皮冠状动脉介入治疗患者术后病死率的关系

Association of hematocrit with postoperative fatality rate in patients undergoing elective percutaneous coronary intervention

作者：刘新民董建增吕强张崟罗太阳关杨郭飞陈晨张骞白融杜昕马长生

英文作者：Liu Xinmin Dong Jianzeng Lyu Qiang Zhang Yin Luo Taiyang Guan Yang Guo Fei Chen Chen Zhang Qian Bai Rong Du Xin Ma Changsheng

单位：首都医科大学附属北京安贞医院心内科国家心血管疾病临床医学研究中心100029

英文单位：Department of Cardiology Beijing Anzhen Hospital Capital Medical University National Clinical Research Center for Cardiovascular Diseases Beijing 100029 China

关键词：经皮冠状动脉介入；血细胞比容；预后

英文关键词：Percutaneouscoronaryintervention;Hematocrit;Prognosis

• 摘要：

• 目的 探讨血细胞比容（HCT）与择期经皮冠状动脉介入（PCI）治疗患者术后病死率的关系。方法 回顾性选取2016年1月至2017年1月在首都医科大学附属北京安贞医院心内科接受择期PCI治疗且术前有HCT记录的患者2 437例，根据世界卫生组织关于贫血的诊断标准（男性HCT＜39%，女性HCT＜36%）将患者分为低HCT组（1 067例）和正常HCT组（1 370例）。比较2组患者临床特点及术后病死率的差异，分析患者术后病死率的影响因素。结果 低HCT组患者住院期间应用血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂比例低于正常HCT组［61.0%（651/1 067）比65.4%（896/1 370）］，合并左主干病变和慢性完全闭塞病变比例高于正常HCT组［3.8%（41/1 067）比2.6%（35/1 370）、12.9%（138/1 067）比9.6%（132/1 370）］（均P＜0.05）。所有患者平均随访1.5年，低HCT组患者术后死亡48例（4.5%），正常HCT组患者术后死亡15例（1.1%），组间比较差异有统计学意义（P＜0.001）。多因素Cox回归分析结果显示，低HCT是患者PCI术后病死率增加的独立危险因素（风险比=3.080，95%置信区间：1.441～6.583，P=0.004）。结论 低HCT是择期PCI患者术后病死率增加的独立危险因素。

• Objective To investigate the association of hematocrit(HCT) with postoperative fatality rate in patients undergoing elective percutaneous coronary intervention(PCI).Methods From January 2016 to January 2017, 2 437 patients who received elective PCI and had preoperative HCT records in Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University were selected retrospectively. According to the world health organization diagnostic criteria for anemia (HCT＜39% for males and ＜36% for females), the patients were divided into low HCT group (1 067 cases) and normal HCT group (1 370 cases). The differences of clinical characteristics and postoperative fatality rate between the two groups were compared, and the influencing factors of postoperative fatality rate were analyzed.Results The proportion of angiotensin converting enzyme inhibitor/angiotensin Ⅱ receptor blocker used during hospitalization in low HCT group was lower than that in normal HCT group［61.0%（651/1 067） vs 65.4%（896/1 370）］, and the proportions of left main artery disease and chronic total occlusion disease in low HCT group were higher than those in normal HCT group［3.8%（41/1 067） vs 2.6%（35/1 370）, 12.9%（138/1 067） vs 9.6%（132/1 370）］（all P＜0.05）. All patients followed-up for an average of 1.5 years, 48 cases (4.5%) died in low HCT group and 15 cases (1.1%) died in normal HCT group, and the difference between the two groups was statistically significant (P＜0.001). Multivariate Cox regression analysis showed that low HCT was an independent risk factor for increasing postoperative fatality rate in patients undergoing PCI (hazard ratio=3.080, 95% confidence interval: 1.441-6.583, P=0.004). Conclusion Low HCT was an independent risk factor for increasing postoperative fatality rate in patients undergoing elective PCI.