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目的:研究红细胞分布宽度(RDW)与急性心肌梗死(AMI)患者心功能分级(Killip分级)的关系,以及与脑钠肽(BNP)和超敏C反应蛋白(hs-CRP)之间的相关性,从而探讨RDW在诊断AMI及判断预后中的作用。方法:回顾性分析了2006年12月-2009年12月入住我院的345例AMI患者,根据临床症状和肺部有无啰音、啰音范围和收缩压进行Killip分级。利用Simens-Bayer Advia 2120全血细胞分析仪、Triage全自动免疫分析系统、Olympus AU5421全自动生化分析仪分别检测患者的RDW、血红蛋白(Hb)、血细胞比容(HCT)、平均红细胞体积(MCV)、BNP以及hs-CRP等指标。分析Killip各级之间RDW的变化趋势,同时对RDW与BNP和hs-CRP之间的相关性进行分析。结果:Killip II级及以上患者的RDW值明显高于Killip I级患者的RDW(13.75 vs13.07,P<0.001),但Killip II级I、II级及IV级之间RDW的结果没有显著差异(P II/III=0.498、P II/IV=0.418、P III/IV=0.817),Killip I级患者的RDW值均位于参考范围内。RDW与BNP显著相关(r=0.178,P<0.05),而与hs-CRP不具有相关性(r=0.065,P>0.05)。在校正了年龄、性别、HGB、HCT和MCV等因素后,BNP仍可独立预测RDW(R2=0.032,P<0.05)。结论:RDW在出现心力衰竭的AMI患者中明显高于心功能正常的AMI患者,可用于判断AMI心力衰竭的发生。
OBJECTIVE: To investigate the relationship between RDW and Killip classification and the correlation between BNP and hs-CRP To explore the role of RDW in the diagnosis of AMI and prognosis. Methods: A retrospective analysis of 345 AMI patients admitted to our hospital from December 2006 to December 2009 was performed Killip grading according to the clinical symptoms and whether the lungs had rales, rales and systolic pressure. The patients were tested for RDW, hemoglobin (Hb), hematocrit (HCT) and mean corpuscular volume (MCV) by using Simens-Bayer Advia 2120 whole blood cell analyzer, Triage automatic immunoassay system and Olympus AU5421 automatic biochemical analyzer. BNP and hs-CRP and other indicators. The trend of RDW between Killip levels was analyzed, and the correlation between RDW and BNP and hs-CRP was analyzed. Results: RDW was significantly higher in patients with Killip class II and higher than in RD patients with Killip class I (13.75 vs. 13.07, P <0.001), but there was no significant difference in RDW between Killip II class I, II, and IV (P II / III = 0.498, P II / IV = 0.418, P III / IV = 0.817). All Killip I patients had RDW values within the reference range. RDW was significantly associated with BNP (r = 0.178, P <0.05), but not with hs-CRP (r = 0.065, P> 0.05). BNP still independently predicted RDW (R2 = 0.032, P <0.05) after adjusting for age, gender, HGB, HCT, and MCV. Conclusion: RDW in AMI patients with heart failure is significantly higher than AMI patients with normal heart function, which can be used to judge the occurrence of AMI heart failure.