血小板分布宽度与冠心病心力衰竭相关性的临床研究

Association between platelet distribution width and heart failure due to coronary heart disease

目的探讨冠心病心力衰竭(心衰)患者血小板分布宽度(PDW)与其他指标的相关性。方法选取冠心病心衰患者591例,按照N末端B型钠尿肽前体(NT-proBNP)值的高低分为对照组(NT-proBNP<300ng/L)228例,轻度心衰组(NT-proBNP 300~3000ng/L)191例,重度心衰组(NT-proBNP>3000ng/L)172例,观察各组血液指标及超声心动图指标。结果与治疗前PDW比较,治疗后PDW对照组、轻度心衰组、重度心衰组显著降低(0.129±0.031 vs 0.133±0.027,0.133±0.030 vs 0.141±0.029,0.139±0.028 vs 0.148±0.029),差异有统计学意义(P<0.05,P<0.01);与对照组比较,轻度心衰组、重度心衰组治疗前后PDW显著升高(P<0.05,P<0.01);与轻度心衰组比较,重度心衰组治疗前后PDW显著升高,差异有统计学意义(P<0.05)。将在Pearson相关分析中具有相关性的指标作为自变量,以治疗前PDW作因变量,多元逐步回归分析显示,PDW与NT-proBNP、左心房直径呈正相关(P=0.001、P=0.000);PDW与LVEF呈负相关(P=0.003)。结论随着冠心病患者心衰严重程度增加,PDW指标逐渐升高,PDW在判断心衰患者病情严重程度方面有辅助作用。

Objective To study the association between platelet distribution width （PDW） and oth- er indexes in coronary heart disease （CHD） patients with heart failure （HF）. Methods Five hundred and ninety-one CHD patients with HF were divided into control group with their NT-proBNP〈300 ng/L （n=228）,mild HF group with their NT-proBNP=300-3000 ng/L （n= 191）,and severe HF group with their NT-proBNP〉3000 ng/L（n= 172）. Their blood and echocardiographic parameters were recorded. Results The PDW was significantly shorter in 3 groups after treatment than before treatment （0. 129±0. 031 vs 0. 133±0. 027,0. 133±0. 030 vs 0. 141± 0. 029,0. 139±0. 028 vs 0. 148±0. 029,P〈0.05,P〈0.01） ,and was significantly longer in mild HF group and severe HF group than in control group and in severe HF group than in mild HF group after tgreatment （P〈0.05,P〈0. 01）. Multivariate stepwise regression analysis showed that PDW was positively associated with NT-proBNP and LAD （P=0. 001 ,P=0. 000） and negatively associated with LVEF （P=0. 003）. Conclusion PDW increases with the severity of HF in CHD patients and can thus play an auxiliary role in assessing the severity of their HF.