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背景红细胞分布宽度(RDW)是以数字表达的红细胞大小变异度,有报道认为RDW增加与心血管事件的发生率和死亡率具有明显的相关性,可能作为心血管事件的预测因素之一;RDW与C反应蛋白一样,是机体炎症水平的一个标志,可能预测非冠心病及冠心病患者的心血管事件发生率和死亡率。目的探讨慢性心力衰竭患者RDW的变化情况及其与心功能分级(NYHA)、脑钠肽(BNP)、高敏C反应蛋白(hs-CRP)、左室射血分数(LVEF)的关系。方法选取慢性心力衰竭患者402例,其中冠心病患者160例、高血压性心脏病者136例、原发性心肌病者47例、心脏瓣膜病者59例,分别检测RDW、BNP、hs-CRP、LVEF等指标并临床评价NYHA。结果随NYHA级别的增加,RDW逐渐升高,RDW值(%)分别为1级(13.4±1.1)、2级(14.0±2.2)、3级(14.9±1.5)、4级(15.8±2.0);RDW与BNP(r=0.567)、NYHA(r=0.439)、hs-CRP(r=0.165)呈正相关(均P<0.01),而与LVEF呈负相关(r=-0.332,P<0.01);RDW值随年龄增加略有上升,但差异无统计学意义(P>0.05)。结论慢性心力衰竭患者RDW与BNP、NYHA、hs-CRP呈正相关,与LVEF呈负相关,且随心功能的恶化,RDW呈上升趋势。
Background The distribution width of red blood cells (RDW) is a digitally expressed red blood cell size variability. It has been reported that there is a clear correlation between the increase of RDW and the incidence of cardiovascular events and mortality, which may be one of the predictors of cardiovascular events. RDW Like C-reactive protein, is a marker of the level of inflammation in the body and may predict cardiovascular events and mortality in non-CHD and CHD patients. Objective To investigate the changes of RDW in patients with chronic heart failure and its relationship with NYHA, BNP, hs-CRP and LVEF. Methods A total of 402 patients with chronic heart failure were selected. Among them, 160 were coronary heart disease patients, 136 hypertensive heart disease patients, 47 primary cardiomyopathy patients and 59 valvular heart disease patients. RDW, BNP, hs-CRP , LVEF and other indicators and clinical evaluation of NYHA. Results With the increase of NYHA level, RDW increased gradually and the RDW values were (level 1) (13.4 ± 1.1), level 2 (14.0 ± 2.2), level 3 (14.9 ± 1.5), level 4 (15.8 ± 2.0) ; RDW was positively correlated with BNP (r = 0.567), NYHA (r = 0.439), hs-CRP (r = 0.165) ; RDW value increased slightly with age, but the difference was not statistically significant (P> 0.05). Conclusion RDW is positively correlated with BNP, NYHA and hs-CRP in patients with chronic heart failure, and negatively correlated with LVEF. RDW shows an upward trend with the deterioration of cardiac function.