红细胞体积分布宽度与慢性心力衰竭心功能指标关系的研究

Correlation between red cell distribution width and cardiac functional parameters determined by ultrasonic echocardiogram in patients with chronic heart failure

目的:研究慢性心力衰竭(CHF)患者红细胞体积分布宽度(RDW)水平与心脏超声心功能指标的关系及临床意义。方法:选取2009-03-2010-03于辽宁医学院附属第一医院心内科住院治疗临床诊断为CHF的176例作为实验组,按照纽约心脏学会(NYHA)分级将其分为NYHAⅠ级31例、NYHAⅡ级39例、NAⅢ级52例、NYHAⅣ级54例。选取门诊健康体检者36例作为对照组。测量其RDW及左室舒张末期内径(LVEDD)、左室射血分数(LVEF)。比较各组的RDW值;利用相关分析研究RDW与LVEDD、LVEF的关系。结果:CHF组RDW高于对照组,差异有统计学意义(P<0.01);CHF组内随着NYHA级别的增高,RDW逐渐升高,各组间两两比较差异均有统计学意义(P<0.05);RDW与LVEDD呈正相关(r=0.759,P<0.01),与LVEF呈负相关(r=-0.743,P<0.01)。结论:RDW是反映心功能受损的敏感指标,与心功能状态和左室重塑有明显的相关性,RDW的检测可对不同程度的CHF患者进行评估,对指导CHF治疗、评价预后均具有重要临床价值。

Objective：To investigate correlation between red cell distribution width（RDW） and cardiac functional parameters determined by ultrasonic echocardiogram in patients with chronic heart failure（CHF） and its diagnostic value of cardiac function.Methods：A total of 176 inpatients with CHF from March 2009 to March 2010 were analyzed as CHF group,while 26 patients without CHF were enrolled as Control group.The patients in CHF group were further divided into 4 subgroups according to the classification of New York Heart Association（NYHA）,including 31,39,52 and 54 patients in Class Ⅰ,Ⅱ,Ⅲ and Ⅳ,respectively.RDW was measured in both groups.Left ventricular ejection fraction（LVEF） and left ventricular end-diastolic diameter（LVEDD） were also evaluated in these groups.Results：Compared with Control group,RDW was significantly increased in CHF group（P0.01）.With NYHA level increased,RDW was increased gradually（P0.05）.RDW in CHF patients was positively correlated with LVEDD（r=0.598,P0.01）,while negatively correlated with LVEF（r=-0.543,P0.01）.Conclusions：As a sensitive marker reflecting the impaired cardiac function,RDW significantly associated with the cardiac function and left ventricle remodeling.By detection of RDW,it helps to evaluate the heart function,and further guide the treatment and prognosis evaluation in heart failure patients.