同型半胱氨酸在预测慢性心力衰竭中的价值  

The value of homocysteine in predicting chronic heart failue

作　　者：区惠梅[1] 梅敏[1] 区志明[1] 刘健[1] 陈平[1] 陈卫军[1] 李肖玲[1] 

机构地区：[1]肇庆市第一人民医院,广东肇庆526060

出　　处：《医学检验与临床》2015年第4期32-34,共3页Medical Laboratory Science and Clinics

摘　　要：目的：探讨同型半胱氨酸（HCY）、RDW和PDW对发生慢性心力衰竭（CHF）的预测价值。方法：收集2012年6月至2014年6月于本院首次确诊的80例CHF患者为观察组，回归性分析在CHF发生前1-3个月测定的HCY 、RDW和PDW与同时期健康对照组80例体检者的差异。结果采用SPSS17.0进行统计分析。结果：CHF患者HCY为（14.5 umol/L±3.25）、RDW值为（16.0±2.22）％和PDW值为（16.8±0.92）％，结果均明显高于对照组，差异有统计学意义（P＜0.05）。运用多因素Logistic回归分析： HCY值、RDW值和PDW值升高是发生CHF的独立危险因子；HCY值预测CHF的ROC曲线中，AUC为0.921；RDW值预测CHF的ROC曲线中， AUC为0.804（95％CI 0.736～0.872）；PDW值预测CHF的ROC曲线中，AUC为0.926（95％CI 0.882～0.970）。HCY与RDW和PDW联合检测的阳性检出率为95.5%。结论：HCY、RDW值和PDW值升高是发生CHF的独立危险因子，三者联合检测能更好地预测的CHF发病风险。Objective：To explore Predictive value about Homocysteine（HCY） and the distribution width of red blood cell and platelet in heart failure. Methods：Eighty cases of patients with heart failure in the first people＇s hospital of Zhaoqing were collected as the observation group in June 2012 to June 2014, in which HCY and RDW and PDW had been detected one to three months before heart failure and compared with those of control group included eighty healthy persons .SPSS17.0 was used to analyze the results.Results：The HCY, RDW, PDW levels of patients with heart failure were（14.0%±3.25 umol/L,P〈0.05）, （16.0%±2.22%,P〈0.05） , （16.8%± 0.92%,P〈 0.05） respectively, which were significantly higher than those of the control group respectively. In multivariate Logistic regression analysis, high levels of HCY and RDW and PDW were independent risk factors of heart failure. The area under receiver operating characteristics curve （AUC） of prediction heart failure of HCY levels was 0.921（95%CI 0.907~0.953）. The AUC of RDW levels was 0.804 （95%CI 0.736 to 0.872）.The AUC of PDW levels was 0.926（95%CI 0.882 to 0.970）. Conclusions：HCY and RDW and PDW could be a good predictive marker for heart failure.

关 键 词：慢性心力衰竭 同型半胱氨酸 红细胞分布宽度 血小板分布宽度 

分 类 号：R541.6[医药卫生—心血管疾病]