红细胞体积分布宽度与慢性心力衰竭相关性.docVIP

红细胞体积分布宽度与慢性心力衰竭相关性 　　【摘要】 目的 研究红细胞体积分布宽度(RDW)与慢性心力衰竭(CHF)患者心功能之间的相关性,并探讨其可能的机制和意义。方法 收集220例CHF患者住院病历资料,根据其左室射血分数(LVEF)分为A组(n=114),LVEF≥50%;B组(n=60),50% LVEF 35% ;C组(n=46),LVEF≤35%组 。另选60例同期住院无CHF患者作为对照组,比较RDW, 血N?末端脑钠肽前体(NT?ProBNP)和Hb等相关因素在各组间的变化差异,分析RDW与NT?ProBNP和LVEF二者之间的相关性,并采用多元线性逐步回归法分析各因素与RDW的相关性。结果 随着LVEF的逐渐下降,RDW和NT?ProBNP皆逐渐升高,并且二者在各组间两两比较均具有显著性差异(P0?05),而与NT?ProBNP,LVEF和BUN之间存在直线相关,其相关系数r分别为0?595,?0?485和0?185,经多元线性逐步回归分析可得出回归方程:RDW=13?793+1?421(LgNT?ProBNP)+ 0?074(BUN)?0?116(LVEF)。结论 CHF患者RDW较正常对照组明显升高,且与心功能成负相关。? 　　【关键词】 　　红细胞体积分布宽度;慢性心力衰竭;N?末端脑钠肽前体;射血分数;相关关系 　　 　　Correlation of red blood cell volume distribution width and chronic heart failure 　　 　　HU Yu,WANG Wei. 　　Department of Cardiology,Taihe Hospital of Shiyuan,Hubei 442100,China 　　? 　　【Abstract】 Objective To study the correlation of red blood cell volume distribution width and chronic heart failure and to explore its possible mechanism and significance? Methods 220 files from 220 patients with chronic heart failure in hospital were collected and divided into 3 groups based on left ventricular ejection fraction(LVEF): group A (n=114),LVEF≥50%.Group B(n=60),50% LVEF 35%.Group C(n=46),LVEF≤35%?80 patients without CHF were selected as the control group(n=82)?To compare the change of RDW,NT?proBNP,Hb in all groups and analyse the correlation between RDW and NT?proBNP,LVEF by linear correlation and the correlation of RDW and a variety of parameters by multiple linearstepwise regression? Results With the decline of LVEF,both RDW and NT?ProBNP gradually increased,and there were significant differences about the two items among the four groups (PLVEF 35% ,60例;C组:LVEF≤35%组 , 46例。? 　　1?2?2 研究指标及其检测 指标包括年龄、性别、LVEF,NT?ProBNP,RDW,血红蛋白(Hb)、血清铁(Fe)、血清尿素氮(BUN)、血??酐(Cr)、左室舒张/收缩末期内径(LVESD/LVEDD)。其中血浆NT?ProBNP由化学发光酶标仪(德国Berthold公司centro LB960)用化学发光法测定。? 　　1?2?3 统计学方法 采用SPSS 13?0软件包进行统计分析。计量资料用均数±标准差表示,组间比较采用One?Way ANOVA分析;血浆NT?ProBNP经对数转换后(LgNT?ProBNP)呈正态分布;计数资料组间比较采卡方检验分析;相关性分析采用线性相关及多元