RDW、MAU、cTnI检测在慢性心力衰竭早期诊断、心功能评估中的应用

Application of RDW,MAU,and cTnI detection in early diagnosis and cardiac function evaluation of chronic heart failure

目的分析红细胞分布宽度(RDW)、微量白蛋白尿(MAU)、肌钙蛋白I(cTnI)检测在慢性心力衰竭(CHF)早期诊断、心功能评估中的应用价值。方法收集2018年10月至2022年4月安徽省皖南康复医院收治的CHF患者98例(CHF组),其中纽约心脏病协会(NYHA)心功能Ⅱ~Ⅳ级至少1个月以上者41例作为心功能失代偿组,NYHAⅠ级者57例作为心功能代偿组。另选取本院同期健康体检者98名作为对照组。对比不同人群、以及心功能代偿组与心功能失代偿组中RDW、MAU、cTnI表达情况;对比CHF组与对照组左房容积指数(LAVI)、左室质量指数(LVMI)、左心室射血分数(LVEF);分析RDW、MAU、cTnI对CHF的诊断价值以及RDW、MAU、cTnI与心功能指标的相关性。结果CHF组RDW、MAU、cTnI值均高于对照组,差异有统计学意义(P<0.05);CHF组LAVI、LVMI高于对照组,LVEF低于对照组,差异有统计学意义(P<0.05);心功能代偿组RDW、MAU、cTnI值均低于心功能失代偿组CHF组(P<0.05)。ROC曲线结果显示:RDW、MAU、cTnI对单独评估CHF曲线下面积(AUC)分别为0.692、0.739、0.718,联合诊断的AUC值为0.859,高于三者单独诊断(P<0.05),联合诊断敏感度、特异度分别为90.60%、85.50%。RDW、MAU、cTnI与LAVI、LVMI指标之间为正相关关系,与LVEF呈负相关关系(P<0.05)。结论RDW、MAU、cTnI在CHF患者中表达明显增高,与患者心功能严重程度密切相关,三指标可为临床早期诊断、患者危险分层工作提供参考。

Objective To analyze the application value of red blood cell distribution width(RDW),microalbuminuria(MAU)and troponin I(cTnI)detection in early diagnosis of chronic heart failure(CHF)and assessment of cardiac function.Methods 98 CHF patients admitted to Wannan Rehabilitation Hospital in Anhui Province from October 2018 to April 2022 were collected(CHF group),among them,the 41 patients with New York Heart Association(NYHA)cardiac functionⅡ~Ⅳfor at least 1 month were select⁃ed as the heart function decompensation group,and 57 patients with NYHA ClassⅠwere selected as the cardi⁃ac function compensation group.Another 98 cases who underwent physical examination in our hospital during the same period were selected as the control group.The expressions of RDW,MAU,and cTnI in different groups of people,as well as in the compensated cardiac function group and the decompensated cardiac func⁃tion group;compared the left atrial volume index(LAVI),left ventricular mass index(LVMI),Left ventric⁃ular ejection fraction(LVEF)of the CHF group and the control group were compared.The diagnostic value of RDW,MAU,cTnI for CHF and the correlation between RDW,MAU,cTnI and cardiac function indicators were analyzed.Results The values of RDW,MAU and cTnI in the CHF group were higher than those in the control group,the difference was statistically significant(P<0.05);the LAVI and LVMI in the CHF group were higher than those in the control group,and LVEF in the CHF group was lower than that in the control group,the difference was statistically significant(P<0.05).The values of RDW,MAU and cTnI in the cardiac function compensation group were lower than those in the cardiac decompensation group and the CHF group(P<0.05).The results of the ROC curve showed that:the area under the curve(AUC)of RDW,MAU,and cTnI for CHF alone was 0.692,0.739 and 0.718,respectively,and the AUC value of the com⁃bined diagnosis was 0.859,which was higher than that of the three alone(P<0.05),the sensitivity and speci⁃ficity of combined diagnosis were 90.60%and 85.50%,respectively.RDW,MAU,cTnI were positively corre⁃lated with LAVI,LVMI,and were negatively correlated with LVEF(P<0.05).Conclusion The expressions of RDW,MAU,and cTnI are significantly increased in CHF patients,which are closely related to the severity of cardiac function,and the three indicators can provide reference for early clinical diagnosis and risk stratifica⁃tion of patients.