慢性心力衰竭患者红细胞分布宽度  

Red Blood Cell Distribution Width in Patients with Chronic Heart Failure

作　　者：陈继升[1] 吴延庆[2] 彭强[2] 黄波[2] 苏海[2] 程晓曙[2] 

机构地区：[1]南昌大学医学院 [2]南昌大学第二附属医院心内科,江西南昌330006

出　　处：《中华高血压杂志》2009年第6期541-545,共5页Chinese Journal of Hypertension

摘　　要：背景红细胞分布宽度(RDW)是以数字表达的红细胞大小变异度,有报道认为RDW增加与心血管事件的发生率和死亡率具有明显的相关性,可能作为心血管事件的预测因素之一;RDW与C反应蛋白一样,是机体炎症水平的一个标志,可能预测非冠心病及冠心病患者的心血管事件发生率和死亡率。目的探讨慢性心力衰竭患者RDW的变化情况及其与心功能分级(NYHA)、脑钠肽(BNP)、高敏C反应蛋白(hs-CRP)、左室射血分数(LVEF)的关系。方法选取慢性心力衰竭患者402例,其中冠心病患者160例、高血压性心脏病者136例、原发性心肌病者47例、心脏瓣膜病者59例,分别检测RDW、BNP、hs-CRP、LVEF等指标并临床评价NYHA。结果随NYHA级别的增加,RDW逐渐升高,RDW值(%)分别为1级(13.4±1.1)、2级(14.0±2.2)、3级(14.9±1.5)、4级(15.8±2.0);RDW与BNP(r=0.567)、NYHA(r=0.439)、hs-CRP(r=0.165)呈正相关(均P<0.01),而与LVEF呈负相关(r=-0.332,P<0.01);RDW值随年龄增加略有上升,但差异无统计学意义(P>0.05)。结论慢性心力衰竭患者RDW与BNP、NYHA、hs-CRP呈正相关,与LVEF呈负相关,且随心功能的恶化,RDW呈上升趋势。Background Previous study showed that the level of red blood cell distribution width （RDW）, a numeral presentation of the variability of red cells size, is related with the incidence of cardiovascular events and mortality. Higher RDW might be one of the predictive factor for cardiovascular events. Objective To investigate the relationship of RDW with NYHA classification of cardiac function, brain natriuretic peptide （BNP）, hypersensitivity C-reactive protein （hs-CRP）, left ventricular ejection fraction （LVEF） in patients with chronic heart failure（CHF）. Methods Four hundreds and two patients with CHF were enrolled, 160 patients were diagnosed by coronary angiography as coronary heart disease （CHD）, 136 with hypertensive heart disease （HTHD） 47 with primary cardiomyopathy （PCM） and 59 with valvular disease of the heart （VDH）. The plasma levels of RDW, BNP, hs-CRP and LVEF were determined. Results With the increasing of NYHA grade, RDW was concomitantly increased [RDW（%）：（13.4±1. 1）, （14.0±2.2）, （14.9±1.5）, （15.8±2.0）, P〈0.05]. There were positive correlation of RDW with BNP （r = 0. 567）, cardiac function （ r = 0. 439 ） and hs-CRP （r = 0. 165, all P〈0.01）, negative correlation with LVEF（r= -0. 332, P〈0.01）. Conclusion The RDW is related with the BNP, hs-CRP, LVEF, cardiac functional grading in patients of chronic heart failure, suggesting RDW may be used to an novel marker for patients with heart failure.

关 键 词：红细胞分布宽度 慢性心力衰竭 心功能 脑钠钛 高敏C反应蛋白 左室射血分数 

分 类 号：R541.6[医药卫生—心血管疾病]