慢性心力衰竭患者红细胞分布宽度与心率变异性的相关性

The relationship between red blood cell distribution width and heart rate variability in patients with chronic heart failure

目的：探讨慢性心力衰竭（CHF）患者红细胞分布宽度（RDW-CV）与心率变异性（HRV）的相关性。方法：选取CHF患者（观察组）和检查正常的老年人（对照组）各80例,比较2组RDW-CV、HRV指标差异,比较观察组中不同心功能分级下RDW-CV、HRV指标差异,对RDW-CV与HRV指标行相关性分析。结果：观察组RDW-CV较对照组升高（P〈0.01）,观察组中24 h窦性R-R间距均值的标准差（SDNN）和5 min窦性R-R间距均值的标准差（SDANN）均较对照组下降（P〈0.01）。心功能Ⅲ-Ⅳ级的患者RDW-CV较心功能Ⅱ级明显升高（P〈0.01）,而SDNN和SDANN均较心功能Ⅱ级明显下降（P〈0.01）。观察组中RDW-CV与SDNN和SDANN均呈负相关关系（P〈0.01）。结论：CHF患者RDW-CV变化与自主神经特别是交感神经过度激活有关。

Objective： To investigate the relationship between red blood cell distribution width（ RDW-CV） and heart rate variability（ HRV） in patients with chronic heart failure（ CHF）. Methods： The RDW-CV and HRV in 80 patients with CHF（ the observation group） and 80 normal old people（ the control group） were compared. The RDW-CV and HRV in patiants with different New York Heart Association cardiac function class were observed,and the correlation of RDW-CV and HRV of which was analyzed. Results： The RDWCV in observation group was higher than that in control group（ P〈0. 01）,the SDNN and SDANN in observation group were lower than those in control group（ P〈0. 01）. The RDW-CV in patients with cardiac function class Ⅲ- Ⅳ was significantly higher than that in patients with cardiac function class Ⅱ（ P〈0. 01）,and the standerd deviatian of the mean of all normal RR intervais within 24 h（ SDNN） and standard deviation of the mean of all 5 minutes segments of normal RR intervals（ SDANN） in patients with cardiac function class Ⅲ- Ⅳ were significantly lower than those in patients with cardiac function class Ⅱ（ P〈0. 01）. The RDW-CV was negatively correlated with the SDNN and SDANN in observation group（ P〈0. 01）. Conclusions： The RDW-CV in CHF patients is associated with autonomic nerve especially the excessive activation of sympathetic nerve.