红细胞分布宽度与心力衰竭及其严重程度的相关性分析

Correlation of red cell distribution width with heart failure and disease severity

目的探讨红细胞分布宽度(RDW)与心力衰竭及其严重程度的相关性。方法回顾性分析驻马店市中心医院2017年1月至2018年12月60例心力衰竭(HF)患者的临床资料,并将其作为HF组,依据纽约心脏病学会(NYHA)心功能分级标准将HF组分为心功能Ⅱ级(24例)、Ⅲ级(20例)、Ⅳ级(16例),纳入同期健康体检者60例为对照组。通过自动生化全血细胞分析仪测定纳入患者RDW水平,并采用超声心动图测定左室舒张末期内径(LVEDd)、左室射血分数(LVEF),分析RDW与心力衰竭及其严重程度的相关性。结果HF组LVEF水平低于对照组,LVEDd、RDW水平高于对照组(P<0.05);RDW水平评估HF发生的受试者工作特征曲线下面积为0.857,敏感度为83.00%,特异度为79.30%;NYHAⅣ级患者LVEF水平低于NYHAⅡ级、Ⅲ级患者,LVEDd、RDW水平高于NYHAⅡ级、Ⅲ级患者(P<0.05);NYHAⅢ级患者LVEF水平低于NYHAⅡ级患者,LVEDd、RDW水平高于NYHAⅡ级患者(P<0.05);RDW与LVEDd水平呈现正相关(r=0.598,P<0.05);RDW与LVEF水平呈现负相关(r=-0.643,P<0.05)。结论RDW与HF严重程度密切相关,RDW随急性心力衰竭程度加重而升高,有助于HF患者严重程度的评估。

Objective To investigate the correlation of red cell distribution width(RDW)with heart failure(HF)and the disease severity.Methods A retrospective analysis was performed on clinical data of 60 HF patients treated in Zhumadian Central Hospital from January 2017 to December 2018.According to cardiac function grading standard of New York Heart Academy(NYHA),patients in HF group were divided into gradeⅡ(24 cases),gradeⅢ(20 cases)and grade IV(16 cases).Sixty healthy persons who underwent physical examination during the same period were enrolled as control group.RDW levels of enrolled objects were measured by automatic biochemical whole blood cell analyzer.The left ventricular end-diastolic diameter(LVEDd)and left ventricular ejection fraction(LVEF)were measured by echocardiography.The correlation of RDW with HF and disease severity was analyzed.Results LVEF level in HF group was lower than that in control group,while levels of LVEDd and RDW were higher than those in control group(P<0.05).The area under the receiver operating characteristic curve(AUC),sensitivity and specificity of RDW level for evaluating occurrence of HF were 0.857,83.00%and 79.30%,respectively.The level of LVEF in patients with NYHA grade IV was lower than that of patients with gradeⅡand gradeⅢ,while levels of LVEDd and RDW were higher than those patients with gradeⅡand gradeⅢ(P<0.05).The level of LVEF in patients with NYHA gradeⅢwas lower than that with gradeⅡ,while levels of LVEDd and RDW were higher than those with gradeⅡ(P<0.05).RDW was positively correlated with LVEDd level(r=0.598,P<0.05),while negatively correlated with LVEF level(r=-0.643,P<0.05).Conclusions RDW is closely related to severity of HF.RDW increases with exacerbation of acute heart failure,which is a reference to severity assessment of HF patients.