红细胞分布宽度和超敏C反应蛋白对射血分数保留心衰的诊断价值分析

The Value of Red Blood Cell Distribution Width and High-sensitivity C-reactive Protein in the Diagnosis of HfpEF

目的:探讨红细胞分布宽度(RDW)和超敏C反应蛋白(hsCRP)对射血分数保留心衰(HFpEF)的诊断价值,为临床诊断提供资料。方法:研究共纳入2013年12月至2016年12月上海市第七人民医院收治的368例CHF患者,对其临床资料进行回顾性分析,用Logisitic回归分析确定HFpEF的独立危险因素,用ROC曲线分析确定RDW和hsCRP对于HFpEF诊断的最佳Cut-off值及其预测价值。结果:HFpEF患者的RDW(12.83±1.09)和hsCRP(8.70±17.81)水平显著低于非HFpEF组患者的RDW(13.58±1.20)和hsCRP(14.24±30.90)水平;较低的RDW(OR=1.831)和hsCRP(OR=1.003)是HFpEF的独立危险因素;对RDW和hsCRP进行ROC曲线分析,hsCRP的AUC为0.814[95%CI(0.758~0.871)],最佳鉴别界值为185.6;RDW的AUC为0.694[95%CI(0.624~0.764)],最佳鉴别界值为13.15。结论:HFpEF患者的RDW和hsCRP水平显著低于非HFpEF型心衰患者,RDW和hsCRP对于HFpEF均有较高的诊断价值,可作为临床诊断HFpEF的参考指标。

Objective： To investigate the value of red blood cell distribution width（RDW） and high-sensitivity C-reactive protein（hsCRP） in the diagnosis of heart failure with preserved left ventricular ejection fraction（HFpEF）. Methods： Three hundred and sixty-eight chronic heart failure patients in Shanghai 7 th people＇s hospital between December 2013 to December 2016, were enrolled. All clinical data of the patients were analyzed retrospectively. The independent risk factor of HFpEF were analyzed with Logistics regression analysis. And the efficiency and accuracy of RDW and hsCRP on diagnosis of HFpEF were evaluated with ROC curve. Results： The level of RDW（12.83±1.09） and hsCRP（8.70±17.81） in HFpEF patients were siginificantly lower than non-HFpEF patients（RDW： 13.58±1.20, hsCRP： 14.24±30.90）. Logistics regression analysis showed that RDW and hsCRP are independent risk factors of HFpEF patients.The AUC of RDW on diagnosis of HFpEF patients is 0.694 [95%CI（0.624~0.764）], with a best optimum boundary value of 13.15. The AUC of hsCRP on diagnosis of HFpEF patients is 0.814 [95% CI（0.758 ~0.871）], with a best optimum boundary value of 185.6.Conclusion： The level of RDW and hsCRP in HFpEF patients are significantly lower than that of non-HFpEF patients. The value of RDW and hsCRP on the diagnosis of HFpEF are high, which suggesting that RDW and hsCRP could be appropriate indicators on the clinical diagnosis of HFpEF.