红细胞体积分布宽度与老年心力衰竭患者心脏功能及生活自理能力关系的研究

Relationship between RDW and cardiac function and activities of daily living in elderly patients with chronic heart failure

目的探讨红细胞体积分布宽度(RDW)与老年心力衰竭患者心脏功能及生活自理能力的关系。方法选取老年心力衰竭患者155例,根据RDW中位数分为A组(RDW≤12.7%)78例、B组(RDW>12.7%)77例。比较2组患者基本临床资料、实验室指标、超声心动图指标及生活自理能力评分的差异。结果与A组比较,B组RDW、年龄、纽约心脏病学会(HYHA)心功能Ⅲ/Ⅳ级比例、心房颤动比例、血尿素氮(BUN)及N末端脑钠肽前体(NT-proBNP)、左心房内径指数(LADi)明显升高;而血红蛋白(HGB)含量、左心室射血分数(LVEF)及生活自理能力(ADL)评分明显降低,差异有统计学意义(P<0.05)。偏相关分析显示,控制年龄、体质量指数(BMI)、HGB、BUN、LADi及NT-proBNP的影响后,RDW与LVEF仍呈负相关(r=-0.191,P=0.019)。控制年龄、BMI、HGB、BUN、NT-proBNP、LADi及LVEF后,RDW与生活自理能力评分仍呈负相关(r=-0.246,P=0.003)。多元线性回归显示,LVEF与NT-proBNP、LADi及RDW独立相关。ADL评分与NT-proBNP、RDW、年龄、HGB及BMI独立相关。结论RDW与老年心力衰竭患者LVEF及ADL评分独立相关。

Objective To investigate the relationship between red blood cell distribution width(RDW)and cardiac function and activities of daily living(ADL)in elderly patients with chronic heart failure.Methods A total of 155 elderly patients with chronic heart failure were selected and divided into group A(78 patients,RDW≤12.7%)and group B(77 patients,RDW>12.7%)according to the median of RDW.Differences in basic clinical data,laboratory parameters,echocardiography and ADL were compared between the two groups.Results Compared with group A,RDW,age,proportion of HYHA cardiac functionⅢ/Ⅳlevel,proportion of atrial fibrillation,blood urea nitrogen and N-terminal pro-B-type natriuretic peptide(NT-proBNP),left atrium diameter index increased significantly in group B;However,hemoglobin content,LVEF and ADL scores were significantly reduced,the differences were statistically significant(P<0.05).Partial correlation analysis showed that after controlling for the effects of age,body mass index,hemoglobin content,blood urea nitrogen,left atrial diameter index and NT-proBNP,RDW was still negatively correlated with LVEF(r=-0.191,P=0.019).After controlling for age,body mass index,hemoglobin content,blood urea nitrogen,NT-proBNP,left atrial diameter index and LVEF,RDW was still negatively correlated with self-care ability score(r=-0.246,P=0.003).Multiple linear regression showed that LVEF was independently correlated with NT-proBNP,left atrial diameter index and RDW.Activities of ADL score was independently correlated with NT-proBNP,RDW,age,hemoglobin content and body mass index.Conclusion RDW is independently correlated with left ventricular ejection fraction and ADL score in elderly patients with chronic heart failure.