贫血与红细胞分布宽度对慢性心力衰竭患者院内死亡的预测价值  

The predictive value of anemia and red blood cell distribution width in patients of in-hospital deaths with chronic heart failure

作　　者：陈南[1] 陆士奇[1] 

机构地区：[1]苏州大学附属第一医院急诊科,江苏苏州215006

出　　处：《中国急救医学》2014年第2期138-141,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨贫血与红细胞分布宽度（red blood cell distribution width,RDW）对慢性心力衰竭患者院内死亡的预测价值.方法 468例慢性心力衰竭患者按住院期间是否死亡分为死亡组和非死亡组.分析两组患者的基本临床资料,按照美国纽约心脏病协会（NYHA）心功能分级进行分组,比较不同心功能组的主要指标,通过二分类Logistic回归分析得出院内死亡的危险因素,绘制ROC曲线分析贫血与RDW对慢性心力衰竭患者院内死亡的预测价值.结果 死亡组的RDW、血红蛋白（Hb）、尿素氮（BUN）及肌酐（Cr）等与非死亡组比较差异有统计学意义（P〈0.05）;随着心功能的不断下降,Hb 明显降低,RDW明显升高,各组比较差异有统计学意义（P〈0.05）;二分类Logistic回归分析显示,Hb、RDW、BUN及Cr等为院内死亡的独立危险因素（P〈0.05）;ROC曲线分析显示,曲线下面积：Hb为0.7235（95%CI 0.213～0.365,P=0.01）,RDW为0.8072（95%CI 0.012～0.280,P=0.000）.结论 贫血与RDW是慢性心力衰竭患者院内死亡的独立预测因子,对慢性心力衰竭患者院内死亡的预测价值较好.Objective To investigate the predictive value of anemia and red blood cell distribution width （RDW） in- hospital deaths with chronic heart failure. Methods 468 heart failure patients, according to whether hospitalization death, were divided into death and non - death group. Analysis was done based on the basic clinical data of two groups of patients, and then according to the New York Heart Association （NYHA） heart function classification, the main indicators of different cardiac function group were compared, and the risk factors of hospital deaths were classified by binary logistic regression analysis. The predictive value of anemia and RDW in - hospital deaths with heart failure were analyzed by drawing ROC curve. Results The differences of RDW, Hb, BUN, Cr and other indicators between death group and non - death group were statistically significant （ P 〈 0.05 ）. With the continuous decline in cardiac function, Hb was decreased and RDW was increased markedly, and the comparative difference between the two groups was statistically significant （ P 〈 0.05 ）. Binary classification logistic regression analysis showed that Hb, RDW, BUN and Cr were independent risk factors for in - hospital deaths （ P 〈 0.05 ） ; ROC curve analysis showed that the area under the curve was 0.7235 for Hb （95 % CI 0.213 - 0. 365, P = 0.01 ） and 0. 8072 for RDW （95 % Cl 0.012 - 0. 280, P = 0. 000）. Conclusion Anemia and RDW is an independent predictor of in - hospital deaths in patients with heart failure, especially for the patients with chronic heart failure.

关 键 词：贫血 红细胞分布宽度(RDW) 慢性心力衰竭 ROC曲线 

分 类 号：R541.61[医药卫生—心血管疾病]