慢性心力衰竭患者红细胞分布宽度与V_1导联P波终末电势的关系及其临床意义

Relationship between red cell distribution width and P-wave terminal force in lead V_1 in patients with chronic heart failure and its clinical significance

目的探讨慢性心力衰竭(CHF)患者红细胞分布宽度(RDW)与心电图V_1导联P波终末电势(Ptf V_1)的关系及其临床意义。方法将100例CHF患者及50例健康体检者分别作为CHF组和对照组,CHF组中纽约心脏病学会(NYHA)心功能分级Ⅱ级33例、Ⅲ级45例、Ⅳ级22例。检测研究对象RDW、Ptf V_1、N末端B型利钠肽原(NT-proBNP)、超敏C反应蛋白(hs-CRP)、左心房内径(LAD)、左室舒张末期内径(LVEDD)和左室射血分数(LVEF)等指标,分析CHF患者RDW与Ptf V_1的相关性及两者与其他指标的相关性。结果 CHF组RDW、NT-proBNP、hs-CRP、LAD、LVEDD水平均高于对照组(均P <0. 05),而Ptf V_1、LVEF均低于对照组(均P <0. 05)。心功能分级Ⅱ、Ⅲ、Ⅳ级CHF患者RDW、NT-proBNP、hs-CRP、LAD、LVEDD水平呈逐渐增高趋势(均P <0. 05),而Ptf V_1、LVEF水平呈逐渐降低趋势(均P <0. 05)。CHF患者血浆RDW水平与NYHA心功能分级、NT-proBNP、hs-CRP、LAD、LVEDD呈正相关(均P <0. 05),而与LVEF、Ptf V_1呈负相关(均P <0. 05); Ptf V_1与NYHA心功能分级、NT-proBNP、hs-CRP、LAD、LVEDD呈负相关(均P <0. 05),而与LVEF呈正相关(P <0. 05)。结论 CHF患者RDW升高而Ptf V_1降低,两者均与CHT患者的心功能状态密切相关。

Objective To investigate the relationship between red cell distribution width（RDW） and P-wave terminal force in lead V 1（PtfV 1） in the patients with chronic heart failure（CHF） and its clinical significance. Methods One hundred patients with CHF and 50 healthy check-up individuals were enrolled as CHF group and control group respectively.The patients in the CHF group were divided into 33 cases of cardiac function class Ⅱ,45 cases of cardiac function class Ⅲ,and 22 cases of cardiac function class Ⅳ according to the New York Heart Association（NYHA） heart function classification.The indices of the subjects were detected,including RDW,PtfV 1,N-terminal pro-B-type natriuretic peptide（NT-proBNP）,high-sensitivity C-reactive protein（hs-CRP）,left atrial diameter（LAD）,left ventricular end-diastolic diameter（LVEDD） and left ventricular ejection fraction（LVEF）,the correlation between RDW and PtfV 1 in the patients with CHF was analyzed,and the correlation of RDW and PtfV 1 with other indices was analyzed as well. Results The levels of RDW,NT-proBNP, hs-CRP,LAD and LVEDD in the CHF group were higher than those in the control group（all P 〈0.05）,while PtfV 1 and LVEF in the CHF group were lower than those in the control group（all P 〈0.05）.In the CHF patients with cardiac function class Ⅱ,Ⅲ and Ⅳ,the levels of RDW,NT-proBNP,hs-CRP,LAD and LVEDD showed a trend to increase gradually（all P 〈0.05）,while the levels of PtfV 1 and LVEF showed a trend to decrease gradually（all P 〈0.05）.In the patients with CHF,the level of plasma RDW positively correlated with cardiac function level assessed by NYHA classification,NT-proBNP,hs-CRP,LAD and LVEDD（all P 〈0.05）,but negatively correlated with LVEF and PtfV 1（all P 〈0.05）;PtfV 1 negatively correlated with cardiac function level assessed by the NYHA classification,NT-proBNP, hs-CRP ,LAD and LVEDD（all P 〈0.05）,but positive correlated with LVEF（ P 〈0.05）. Conclusion RDW increases and PtfV 1 decreases in the CHF patients,the decline of RDW and PtfV 1 might closely correlate with the cardiac function of CHF patients.