红细胞分布宽度对心力衰竭合并贫血患者远期预后的预测价值  

Predictive value of red blood cell distribution width on long-term prognosis of patients with heart failure and anemia

作　　者：李爱华[1] 唐良秋[1] 张社兵[1] 刘向阳[1] 陈锦峰[1] LI Aihua;TANG Liangqiu;ZHANG Shebing;LIU Xiangyang;CHEN Jinfeng(Department of Internal Cardiovascular Medicine YueBei People’s Hospital,GuangDong 512000,China)

机构地区：[1]韶关市粤北人民医院心血管内科,512000

出　　处：《心肺血管病杂志》2021年第1期24-28,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨红细胞分布宽度(RDW)对心力衰竭(HF)合并贫血患者远期预后的预测价值。方法:选择2016年1月至2017年1月,在我院住院的EF降低型心力衰竭(HFrEF)合并贫血患者227例,分析随访3年后患者的死亡情况及RDW对死亡率的预测价值。结果:平均随访时间34个月,随访期间发生78例(34.4%)死亡;死亡组RDW明显大于非死亡组[(15.78±2.09)%vs.(14.26±1.63)%,P=0.001)组间比较,差异有统计学意义;诊断ROC曲线下面积(AUC)为0.780(Z=6.806,P=0.003),诊断折点为15.1,对应敏感度84.2%,特异性87.5%,Youden指数0.38;RDW与HGB(r=-0.231,P=0.007)、MCHC(r=-0.583,P=0.001)、eGFR(r=-0.308,P<0.001),NT-proBNP(r=-0.415,P=0.028)呈负相关,与肌酐(r=0.358,P=0.002)呈正相关。COX回归分析表明RDW、RDW≥15.3、RDW≥15.1、NT-proBNP是死亡的预测因素(P<0.05)。结论:RDW是病情稳定的HFrEF患者远期预后的危险因素。Objective:To evaluate the effect of red blood cell distribution width(RDW)on mortality of patients with heart failure(HF)combined with anemia.Methods:From January 2016 to January 2017,227 patients with anemic anemia(HFrEF)were enrolled in our hospital.The mortality of patients and the predictive value of RDW on mortality after 3 years were followed up.Results:The average follow-up time was 34 months(29-41)and 78 cases(34.4%)died during follow-up.The RDW in death group was significantly greater than non-death group(15.78±2.09)%vs.(14.26±1.63)%and the difference between the groups was statistically significant(t=5.982,P=0.001).Area of the ROC curve(AUC)was 0.780(Z=6.806,P=0.003)and the break point was 15.1.The sensitivity was 84.2%,specificity was 87.5%and Youden index was 0.38;RDW was negatively correlated with hemoglobin(r=-0.231,P=0.007),MCHC(r=-0.583,P=0.001),eGFR(r=-0.308,P<0.001),NT-proBNP(r=-0.415,P=0.028)and was positively correlated with creatinine(r=0.358,P=0.002).COX regression analysis showed that RDW,RDW>15.3,RDW>15.1,and NT-proBNP were independent predictors for death(P<0.05).Conclusions:RDW is an independent risk factor for long-term prognosis in patients with stable HFrEF.

关 键 词：红细胞分布宽度 心力衰竭 贫血 死亡率 

分 类 号：R54[医药卫生—心血管疾病]