急性失代偿心力衰竭的住院患者红细胞分布宽度和Ⅰ型心肾综合征的关系

Relation between red blood cell distribution width and type 1 cardio-renal syndrome in hospitalized patients with acute decompensated heart failure

目的：研究急性失代偿心力衰竭（ADHF）患者红细胞分布宽度（RDW）和Ⅰ型心肾综合征（CRS）之间的关系。方法：回顾性病例-对照研究。收集因ADHF在我院心内科住院患者的病历资料。用改善全球肾脏病预后组织（KDIGO）的急性肾损伤标准评估Ⅰ型CRS并分级。结果：本研究共纳入445例患者,其中140例（31.5%）发生Ⅰ型CRS,其RDW水平显著高于无Ⅰ型CRS者[（15.9±1.4）vs.（13.2±0.8）,P〈0.01]。AKI亚组1-3级的RDW水平分别为（14.2±1.2）、（15.8±1.9）和（16.4±2.2）,P=0.028,有递增趋势。多变量Logistic回归模型中,经年龄、糖尿病、脑钠肽和基线估算肾小球滤过率校正后,RDW每增加1单位,Ⅰ型CRS发生风险增加39.8%（OR值1.398,95%CI1.024-1.570）。结论：RDW和ADHF患者发生急性肾损伤独立相关,可能是一种新的Ⅰ型CRS标志物。

Objective：To investigate the relation between red blood cell distribution width and type 1cardio-renal syndrome（CRS）in hospitalized patients with acute decompensated heart failure（ADHF）.Method：This was a retrospective case-control study.Clinical data of hospitalized patients with ADHF were collected.The type 1CRS was diagnosed and degraded by KDIGO criteria for acute kidney injury（AKI）.Result：Clinical date from 445 patients were collected,including 140 with type 1CRS.The patients with CRS had a higher RDW level than those without[（15.9±1.4）vs（13.2±0.8）,P〈0.01].The RDW levels in AKI subgroups from grade 1to 3were（14.2±1.2）,（15.8±1.9）and（16.4±2.2）（P=0.028）,with an increased tendency.In multivariable logistic regression model,the CRS risk increased 39.8% for every 1unit increase of RDW,after adjusted by age,diabetes,hemoglobin,brain natriuretic peptide and basal estimated glomerular filtration rate（95% confidential interval of odds ratio 1.024~1.570）.Conclusion：RDW was independently associated with AKI in ADHF patients,suggesting it might be a novel marker of type 1CRS.