小儿扩张型心肌病并心力衰竭红细胞分布宽度与心功能关系研究

Association between red cell distribution width and heart failure in children with dilated cardiomyopathy complicated with heart failure

目的观察扩张型心肌病(DCM)并发心力衰竭患儿红细胞分布宽度(RDW)水平的变化,并探讨其与常用心功能评价指标的相关性。方法收集武汉市妇女儿童医疗保健中心2012年1月至2014年12月收治的并发心力衰竭的DCM患儿68例,按改良Ross评分法,将其分为轻度、中度、重度心力衰竭组,选取健康体检儿童50名作为对照组,比较各组间RDW水平的差异,并将DCM患儿RDW与血浆N-端脑利钠肽前体(NT-pro BNP)、左室射血分数(LVEF)进行相关性分析。结果 DCM合并心力衰竭组RDW水平较对照组明显升高,差异有统计学意义(P<0.01)。心力衰竭轻度、中度、重度患儿间NT-pro BNP水平逐级升高,LVEF逐级下降,差异有统计学意义(P均<0.01),而心力衰竭各组间RDW水平差异无统计学意义。RDW与NT-pro BNP、LVEF均无显著相关性(r分别为0.144、-0.158,P均>0.05)。结论 RDW升高有助于小儿DCM合并心力衰竭的诊断,但其能否作为小儿心力衰竭严重程度的判断指标尚不能明确。

Objective To observe the changes of red cell distribution width （RDW） in children with heart failure sec- ondary to dilated cardiomyopathy （DCM）, and to explore the correlations between RDW and the common parameters of cardiac function. Methods Totally 68 children with heart failure secondary to DCM were enrolled. According to the modified Ross scoring system, the children were divided into 3 subgroups ： mild, moderate and severe heart failure sub- groups. Fifty healthy children were selected as control group. RDW levels were compared among the groups. The correla- tion analysis was performed between RDW and plasma N-terminal brain natriuretic peptide （NT-proBNP）as well as left ventricular ejection fraction（LVEF）. Results RDW levels in children with heart failure secondary to DCM were signifi- cantly higher than the control group （P 〈 0.01）.With increasing heart failure grade, NT-proBNP levels were elevated gradually and LVEF were decreased gradually （both P 〈 0.01） ;RDW levels had no significant difference among the heart failure groups （P 〉 0.05）. RDM was not correlated with NT-proBNP or LVEF （r = 0.144, r =-0.158, P 〉 0.05）. Conclusion In children with DCM, RDW can be used as a new diagnostic marker of heart failure, but it can not reflect the severity of heart failure.