红细胞分布宽度变化与缺血性心脏病导致急性左心室收缩功能不全的相关性研究  

Relation between changes in red cell distribution width and acute left ventricular systolic dysfunction caused by ischemic heart disease

作　　者：张倩[1] 师树田[1] 孙晓东[1] 魏璐佳 曹晓菁[1] 叶明[1] 王旭[1] 祖晓麟[1] 艾辉[1] 聂绍平[1] ZHANG Qian;SHI Shutian;SUN Xiandong;WEI Lujia;CAO Xiaojing;YE Ming;WANG Xu;ZU Xiaolin;AI Hui;NIE Shaoping(Department of Emergency, Beijing Anzhen Hospital, Capital Medicine University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所急危重症中心,100029

出　　处：《心肺血管病杂志》2018年第6期502-505,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家高技术研究发展计划(863)重大项目(2015AA020102);北京市医管局重点医学发展计划(ZYLX201710)

摘　　要：目的:探讨红细胞分布宽度与缺血性心脏病导致急性左心室收缩功能不全的相关性。方法:回顾性分析了从2016年1月到2016年6月,我院急诊收治的缺血性心脏病导致急性左心室收缩功能不全的患者657例,记录所有患者入院24h内的红细胞分布宽度(RDW),左心室射血分数(LVEF),以及1个月的病死率。结果:RDW>14.5的患者比RDW≤14.5的患者病死率升高,LVEF值降低。[38(22.9%)vs.53(10.8%),(29.6±9.5)%vs.(35.8±8.3)%,P<0.05]。RDW随LVEF值的降低而逐渐升高。年龄,HGB,RDW,高血压史,是预测严重急性左心室收缩功能不全(EF≤35%)的危险因素。OR=1.08,95%CI:1.04~1.12;OR=2.15,95%CI:1.16~3.14;OR=0.87,95%CI:0.75~0.98;OR=1.06,95%CI:1.02~1.11,P<0.05]。RDW诊断急性左心室收缩功能不全的准确性是67.3%(95%CI:62.2~72.3)。敏感性是57.2%,特异性是69.5%。结论:红细胞分布宽度与缺血性心脏病导致急性左心室收缩功能不全的严重程度相关,是简单,经济,快速,准确的预测因子。Objective： To investigate relation between changes in red cell distribution width and acute left ventricular systolic dysfunction caused by ischemic heart disease. Methods： This is a retrospective analysis of 657 patients with acute left ventricular systolic dysfunction caused by ischemic heart disease. Red cell distribution width（ RDW）,left ventricular ejection fraction（ LVEF） and 1 month-mortality rate were measured. Results： In RDW 14. 5 group,1 month-mortality rate was much higher and LVEF was lower than that in RDW≤14. 5 group. [38（ 22. 9%） vs. 53（ 10. 8%）,（ 29. 6 ± 9. 5） vs.（ 35. 8 ± 8. 3） ]（ P〈0. 05）. Age,RDW,hemoglobin and history of hypertension were identified as independent predictors of severe LV systolic dysfunction（ EF≤35%）. OR = 1. 08,95% CI： 1. 04-1. 12; OR = 2. 15,95% CI： 1. 16-3. 14; OR = 0. 87,95% CI： 0. 75-0. 98; OR = 1. 06,95% CI： 1. 02-1. 11,P〈0. 05.Levels of RDW were associated with the presence of severe LV systolic dysfunction,with an accuracy of（ 67. 3%,95% CI： 62. 2-72. 3）,a sensitivity of 57. 2%,a specificity of 69. 5%. Conclusion： RDW may be used as a prognostic tool in HF patients with ischemic heart disease. It is an simple,rapidly,inexpensive,accurate test.

关 键 词：红细胞分布宽度 左心室射血分数 病死率 

分 类 号：R54[医药卫生—心血管疾病]