先天性心脏病并慢性心力衰竭患儿红细胞分布宽度与心功能的关系  

The correlation between red cell distribution width and chronic heart failure in children with congenital heart disease

作　　者：孙东明[1] 夏琨[1] 刘玲[1] 王瑞耕[1] 尹薇[1] 

机构地区：[1]武汉市妇女儿童医疗保健中心心内科,430016

出　　处：《中华实用儿科临床杂志》2016年第1期59-61,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的观察先天性心脏病（先心病）并慢性心力衰竭（心衰）患儿红细胞分布宽度（RDW）、血浆N-端脑利钠肽前体（NT-proBNP）水平的变化，并探讨其与心功能的关系。方法收集2014年1月至12月在武汉市妇女儿童医疗保健中心住院的并慢性心衰及肺炎的先心病患儿84例，按改良Ross评分法，将其分为轻度、中度、重度心衰组。随机选取同期住院的肺炎患儿45例作为对照组。比较各组RDW、血浆NT-proBNP水平的差异，并进行相关性分析。结果先心病并慢性心衰组RDW、血浆NT-proBNP水平均较对照组明显升高，差异有统计学意义[（15．6±2．2）％比（13．7±1．5）％，（3252．9±1061．5）ng／L比（67．4±17．9）ng／L，t=5．518、7．838，P均〈0．01]。心衰轻度、中度、重度患儿间NT—proBNP水平逐级升高，差异有统计学意义[（1718．3±456．2）ng／L比（3371．4±834．2）ng／L比（4681．2±1214．8）ng／L，F=15．961，P〈0．01]，RDW水平亦逐级升高，但差异无统计学意义[（15．2±1．5）％比（15．7±2．0）％比（16．0±2．8）％，F=2．246，P〉0．05]。先心病并慢性心衰患儿RDW与NT．proBNP水平无显著相关性（r=0．134，P〉0．05）。结论RDW、血浆NT-proBNP水平的升高有助于先心病并慢性心衰的诊断。NT-proBNP水平对先心病并慢性心衰的病情评估有重要价值，但RDW能否作为先心病并慢性心衰严重程度的判断指标尚不能明确。Objective To observe the changes in red cell distribution width （RDW） and plasma N - terminal pro- brain natriuretic peptide（ NT- proBNP） in children with chronic heart failure due to congenital heart disease （ CHD）, and to investigate their correlations with cardiac function. Methods Eighty - four children with chronic heart failure and pneumonia secondary to CHD who were hospitalized in Wuhan Health Care Center for Women and Children from January to December 2014 were enrolled. According to the modified Ross scoring system, they were divided into 3 subgroups ： mild, moderate and severe heart failure subgroups. Forty - five children with pneumonia who were hospitali- zed during the same period were randomly selected as the control group. Then the levels of RDW and plasma NT - proBNP were compared in each group,and the correlation between RDW and NT - proBNP was analyzed. Results The levels of RDW and plasma NT - proBNP in children with heart failure caused by CHD were significantly higher than those of the control group[ （15.6 ±2.2）% vs （13.7 ± 1.5）% ,（3 252.9 ± 1 061.5） ng/L vs （67.4 ± 17.9） ng/L, t = 5. 518,7. 838, all P 〈 0.01 ]. NT - proBNP levels were gradually increased along with increasing heart failure grade, and there were statistically significant differences[ （ 1 718.3 ±456.2） ng/L vs （3 371.4 ± 834.2） ng/L vs （4 681.2 ± 1 214.8 ） ng/L, F = 15.961, P 〈 0.01 ]. RDW levels also increased gradually, while there were no statistically signifi- cant differences [ （ 15.2 ± 1.5 ） % vs （ 15.7 ± 2. 0） % vs （ 16.0 ± 2.8 ） %, F = 2. 246, P 〉 0.05 ]. There was no signifi- cant correlation between RDM and NT - proBNP （ r = 0. 134,P 〉 0.05 ）. Conclusions For children with CHD, higher RDW and NT - proBNP levels can aid in the diagnosis of chronic heart failure, and NT - proBNP level is associated with the severity of heart failure, yet it is still unclear whether RDW level can reflect the severity of heart failure.

关 键 词：先天性心脏病 心力衰竭 红细胞分布宽度 N-端脑利钠肽前体 

分 类 号：R725.4[医药卫生—儿科]