红细胞分布宽度与慢性心力衰竭患者心功能指标的相关性研究  

Correlation between red blood cell distribution width and cardiac function in patients with chronic heart failure

作　　者：刘晶[1] 李英梅[1] 刘欣艳[1] 杨晓燕[1] 李彩荣[1] LIU Jing LI Ying-mei LIU Xin-yan YANG Xiao-yan LI Cai-rong(Shanghai Putuo District Central Hospital, Shanghai 200062, Chin)

机构地区：[1]上海市普陀区中心医院,上海200062

出　　处：《中国预防医学杂志》2017年第5期330-333,共4页Chinese Preventive Medicine

基　　金：上海市卫计委项目(201540264);上海市普陀区科委自主创新项目(2013PTKW021)

摘　　要：目的了解红细胞分布宽度(red blood cell distribution width,RDW)与慢性心力衰竭(chronic heart failure,CHF)患者不同纽约心脏协会(New York heart Association,NYHA)心功能分级的关系。方法收集300例CHF住院患者作为心衰组,根据临床症状进行心功能分级,同期于体检站纳入300例体检健康的志愿者作为对照组,通过检测两组RDW、左室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)和BNP,比较两组RDW、LVEF、LVEDD和BNP的差异;对不同心功能分级的CHF患者进行RDW水平分析;线性回归分析RDW与NYHA心功能分级、LVEF和BNP的相关性。结果 CHF患者RDW、BNP和LVEDD分别为(15.67±2.13)%,(412.18±17.96)ng/L和(55.85±1.86)mm,高于健康对照组的(13.12±2.09)%,(92.73±12.74)ng/L和(45.68±2.17)mm,差异有统计学意义(P<0.05),CHF患者的LVEF为(43.87±2.48)%,低于对照组的(66.64±2.88)%,差异有统计学意义(P<0.05);随着NYHA分级逐渐增加,BNP、LVEDD逐渐升高,LVEF值逐渐下降,RDW值呈现逐渐升高的变化趋势(P<0.05);线性相关分析显示,RDW与NYHA分级和BNP呈正相关,与LVEF呈负相关(P<0.05)。结论 CHF患者RDW与NYHA心功能密切相关;RDW可能成为临床评估心力衰竭病情严重程度的指标。Objective To understand the correlation between red blood cell distribution width （RDW） and NY- HA classification of cardiac function in patients with chronic heart failure （CHF）, and to discuss the relation- sbip of RDW with left ventricular ejection fraction （LVEF） and brain natriuretie peptide （BNP） in patients with CHF. as well as to analyze the correlation of red Mood cell distribution with the prognosis of disease. Methods 300 cases with CHF were recruited into the study and NYHA classification of cardiac function was performed based on their clinical symptoms. Meanwhile, 300 healthy volunteers were enrolled as study con trols. The RDW, left ventricular ejection fraction （LVEF）, left ventricular end diastolic diameter （LVEDD） and brain natriuretic peptide （BNP） of all subjects were measured and compared. RDWs of patients with differ- ent classification of cardiac function were analyzed. The correlations of RDW with NYHA classification of car diac function, LVEF and BNP were analyzed by linear regression analysis. Results The RDW, BNP, I.VEF, LVEDD of patients with CHF were significantly higher than those of controls （15.67±2.13 vs. 13.12 ±2.09; 412.18±17.96 vs. 92.73±12.74; 55.85±1.86 vs. 45.68±2.17; P〈0.05）, while the LVEF of patients was statistically lower than that of controls （43.87±2.48 vs. 66.64±2.88; P〈0.05）. With NYHA classification level gradually increasing, me pier ainu 5 ~ declined, RI）W showed a rising trend. The liner regression analysis showed that RDW was positively correlated with NYHA classification and BNP, but negatively correlated with LVEF （P〈0.05）. Conclusions In- creased RDW level of patients with CHF may be closely related to the heart function. RDW may also be a valu- able indicator for the assessment of clinical heart fallure and for the prediction of disease prognosis.

关 键 词：红细胞分布宽度 慢性心力衰竭 心功能分级 左室射血分数 脑钠肽 

分 类 号：R541.6[医药卫生—心血管疾病]