慢性心力衰竭患者外周血RDW与HDL-C水平的相关性分析  

Relationship between High-density Lipoprotein Cholesterol and the Red Cell Distribution Width in Patients with Chronic Heart Failure

作　　者：唐红秀 王璐[2] 万楠[2] 胡晓芳[2] TANG Hong -xiu, WANG Lu, WAN Nan, HU Xiao -fang(Post Graduate Training Base of Shenyang Military Region General Hospital of Jizhou Medical University, Liaoning Jinzhou 121000 China; Department of Ctinicat Laboratory, the General Hospital of Shenyang Military, Shenyang 110016, China)

机构地区：[1]锦州医科大学沈阳军区总医院研究生培养基地,辽宁锦州121000 [2]沈阳军区总医院检验科,沈阳110016

出　　处：《现代检验医学杂志》2018年第6期88-90,94,共4页Journal of Modern Laboratory Medicine

摘　　要：目的研究慢性心力衰竭患者外周血红细胞分布宽度(RDW)与高密度脂蛋白胆固醇(HDL-C)水平之间的关系。方法以沈阳军区总医院2016年8月～2018年8月门诊收治的162例慢性心力衰竭(chronic heart failure,CHF)患者为研究对象,用四分位数法将CHF患者分为四组,检测其RDW,HDL-C,hs-CRP和NT-proBNP等值,观察RDW与HDL-C之间的关系,采用单因素方差分析、秩和检验(Kruskal Wallis)与Pearson相关对数据进行统计学分析。结果四组患者分别为39例、41例、38例和44例;四组HGB(g/L)的水平分别为129.16±27.54,133.07±21.51,130.89±16.08和121.86±26.04;四组Cr(μmol/L)的水平分别为74.2(55.62～88.08),80.14(63.00～95.25),77.30(64.03～91.57)和84.36(66.5～106.91);四组LDL-C(mmol/L)的水平分别为2.45±0.69,2.40±0.85,2.43±0.87和2.12±0.53,将HGB,Cr和LDL-C值在四组间进行比较,差异均无统计学意义(F=1.854,P=0.140;H=4.740,P=0.192;F=1.865,P=0.138)。四组hs-CRP(mg/L)的水平分别为1.60(0.80～2.60),2.80(2.00～6.30),5.8(3.00～13.30)和8.80(4.20～19.45);四组HDL-C(mmol/L)的水平分别为1.11±0.28,1.05±0.21,1.01±0.33和0.87±0.23,将hs-CRP和HDL-C值在四组间进行比较,差异有统计学意义(H=44.106,P<0.001;F=6.546,P<0.001)。CHF患者的RDW与HDL-C水平呈负相关(r=-0.509,P<0.001),与hs-CRP呈正相关(r=0.341,P<0.001),与NT-proBNP相关性较低,且无统计学意义(r=0.107,P=0.174)。心功能分级越高,RDW的值也越高,心功能Ⅳ级患者的RDW值与心功能Ⅱ,Ⅲ级患者比较,差异均具有统计学意义(F=9.391,P=0.003;F=8.648,P=0.004)。结论 CHF患者RDW与血清HDL-C存在负相关,并且RDW值随着心衰的严重程度增加而增加。Objective To explore the relationship between red blood cell distribution width and high density lipoprotein cho lesterol in patients with chronic heart failure（CHF）. Methods 162 patients with CHF in the General Hospital of Shenyang Military from August 2016 to August 2018 were enrolled with a retrospective analysis, the levels of RDW, HDL- C, hs CRP and NT proBNP were detected and Statistical analysis with One way ANOVA, rank sum test （Kruskal Wallis） and Pearson on the data. Results The four groups of patients were 39,41, 38 and 44. The levels of the four groups of HGB （g/L） were 129. 16 ± 27.54, 133.07 ± 21. 51, 130.89 ± 16.08 and 121. 86 ± 26.04, the levels of the four groups of Cr （μmol/L） were 74.2 （55. 62±88. 08） ,80.14 （63.00-95.25）,77.30 （64. 03-91. 57） and 84.36 （ 66. 5-106. 91）. The levels of the four groups of LDL C （mmol/L） were 2.45±0.69,2.40±0.85,2.43±0.87 and 2.12±0.53. HGB,Cr and LDL C values were compared between the four groups, and the difference was not statistically significant （F=1. 854, P=0. 140; H= 4. 740, P= 0. 192; F=1. 865, P=0. 138）. The levels of the four groups of hs CRP （mg/L） were 1. 60 （0. 80- 2.60） , 2.80 （2.00- 6.30） ,5.8 （3.00-13.30） and 8.80 （4.20-19.45）. The levels of the four groups of HDL -C （mmol/L） were 1. 11±0.28, 1. 05±0.21, 1. 01 ± 0.33 and 0.87 ± 0.23, hs CRP and HDL C values were compared between the four groups, and the difference was statistically significant （ F=44. 106, P〈0.001 ; H=6. 546, P〈0. 001）. RDW was negatively correlated with HDL C level in CHF patients （ r=- 0. 509, P〈0.00]）, positively correlated with hs CRP （r=0.341, P〈0. 001）, low cot relation with NT proBNP and had no significantly statistical differences. The change of RDW value increases with the in creasing of cardiac function classification, there were significantly statistical differences between Cardiac function grade and cardiac function grade Ⅱ,Ⅲ in CHF patients （F =9. 391, P =0. 003; F=

关 键 词：慢性心衰 红细胞分布宽度 高密度脂蛋白胆固醇 

分 类 号：R541.6[医药卫生—心血管疾病] R446.11[医药卫生—内科学]