红细胞分布宽度及糖类抗原125水平与老年慢性心力衰竭病人心功能的相关性

Correlations of red blood cell distribution width and carbohydrate antigen 125 level with cardiac function in elderly patients with chronic heart failure

目的探讨红细胞分布宽度(RDW)及糖类抗原125(CA125)与老年慢性心力衰竭(CHF)病人心功能分级之间的关系,随访不同转归病人的RDW及CA125水平变化,评价临床意义。方法选取2013年12月至2015年12月我院干部病房住院的95例老年CHF病人作为CHF组,按照纽约心脏协会(NYHA)心功能分级将其分为3组:心功能Ⅱ级组35例,心功能Ⅲ级组32例,心功能Ⅳ级组28例,收集同期干部门诊30例无CHF病史的老年病人作为对照组。对心功能Ⅲ~Ⅳ级组的病人进行为期3个月的随访,根据病情转归分为治疗改善组及再入院组,分别测定RDW、CA125、B型利钠肽(BNP)、左心室射血分数(LVEF)指标,并进行组间比较。结果CHF组的RDW与CA125水平高于对照组(P<0.05),且随病人心功能恶化程度的加重而逐步上升(P<0.05),心功能Ⅲ~Ⅳ级组病人中,治疗改善组RDW、CA125水平与治疗前相比明显下降(P<0.05),而再入院组无下降。结论 RDW及CA125水平与心功能NYHA分级及病人治疗转归相关,有助于临床对老年CHF病人的筛查、严重程度评估及进行疗效评价。

Objective To investigate the relationship of red blood cell distribution width（RDW）and carbohydrate antigen 125（CA125） with chronic heart failure（CHF） in elderly patients,and to evaluate the clinical significance of RDW and CA125 levels in patients with different outcome.Methods A total of 95 elderly patients with CHF in our hospital from December 2013 to December 2015 were divided into three groups according to the New York Heart Association（NYHA） ： grade Ⅱ group（n =25）,grade Ⅲ group（n = 32） and grade Ⅳ group（n = 28）.Thirty elderly patients without CHF history were collected as the control group.The patients with Ⅲ-Ⅳ cardiac function were followed up for 3 months.According to the outcome of the disease,the patients were divided into the effective group and re-admission group.RDW,CAl25,BNP and left ventricular ejection fraction（LVEF） were measured and compared between the groups.Results The levels of RDW and CA125 in elderly patients with CHF were higher than those in the control group（P0.05）.The level of RDW increased gradually with the deterioration of cardiac function（P 0.05）.In the patients of grade Ⅲ-Ⅳ group,the RDW and CA125 levels in the effective group were significantly lower than those before threatment（P 0.05）.Conclusions The levels of RDW and CA125 are related to the NYHA classification and treatment outcome of CHF,which show values in severity assessment and evaluation of the efficacy in the elderly patients with CHF.