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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(P<0.05)。经相关性分析,RDW与年龄,血清Fe和Hb等因素之间均不存在直线相关关系(P>0.05),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。
Objective To study the correlation between RDW and heart function in patients with chronic heart failure (CHF) and to explore its possible mechanism and significance. Methods The hospital records of 220 patients with CHF were collected and divided into group A (n = 114), LVEF≥50%, group B (n = 60) and LVEF of 35% according to their left ventricular ejection fraction ; Group C (n = 46), LVEF≤35% group. Sixty patients with the same period of hospitalization without CHF were selected as the control group. The differences of RDW, NT-ProBNP and Hb between the two groups were compared. The correlation between RDW and NT-ProBNP and LVEF between the two, and using multivariate linear stepwise regression analysis of the relationship between various factors and RDW. Results With the gradual decrease of LVEF, both RDW and NT-ProBNP gradually increased, and there was a significant difference between the two groups (P <0.05). There was no linear correlation between RDW and age, serum Fe and Hb (P> 0.05), but there was a linear correlation between RDW and NT-ProBNP, LVEF and BUN, the correlation coefficient r was 0.595, -0.485 and 0.185. The regression equation was obtained by multivariate linear stepwise regression analysis: RDW = 13.793 + 1.421 (LgNT-ProBNP) +0.074 (BUN) -0.116 (LVEF). Conclusion The RDW in CHF patients is significantly higher than that in normal controls and negatively correlated with cardiac function.