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目的:研究慢性心力衰竭(CHF)患者红细胞体积分布宽度(RDW)水平与心脏超声心功能指标的关系及临床意义。方法:选取2009-03-2010-03于辽宁医学院附属第一医院心内科住院治疗临床诊断为CHF的176例作为实验组,按照纽约心脏学会(NYHA)分级将其分为NYHAⅠ级31例、NYHAⅡ级39例、NAⅢ级52例、NYHAⅣ级54例。选取门诊健康体检者36例作为对照组。测量其RDW及左室舒张末期内径(LVEDD)、左室射血分数(LVEF)。比较各组的RDW值;利用相关分析研究RDW与LVEDD、LVEF的关系。结果:CHF组RDW高于对照组,差异有统计学意义(P<0.01);CHF组内随着NYHA级别的增高,RDW逐渐升高,各组间两两比较差异均有统计学意义(P<0.05);RDW与LVEDD呈正相关(r=0.759,P<0.01),与LVEF呈负相关(r=-0.743,P<0.01)。结论:RDW是反映心功能受损的敏感指标,与心功能状态和左室重塑有明显的相关性,RDW的检测可对不同程度的CHF患者进行评估,对指导CHF治疗、评价预后均具有重要临床价值。
Objective: To investigate the relationship between the volume distribution of RDW in patients with chronic heart failure (CHF) and the cardiac function of echocardiography and its clinical significance. METHODS: A total of 176 patients with CHF diagnosed in the Department of Cardiology, the First Affiliated Hospital of Liaoning Medical College were selected as the experimental group from March 2009 to March 2010, and were divided into NYHA class Ⅰ (n = 31), NYHA class Ⅰ (n = NYHA class Ⅱ 39 cases, NA Ⅲ class 52 cases, NYHA Ⅳ class 54 cases. Thirty-six outpatients were selected as control group. Their RDW and left ventricular end diastolic dimension (LVEDD) and left ventricular ejection fraction (LVEF) were measured. The RDW values of each group were compared. The relationship between RDW and LVEDD and LVEF was studied by correlation analysis. Results: The RDW in CHF group was significantly higher than that in control group (P <0.01). The RDW increased gradually with the increase of NYHA level in CHF group, and there was significant difference between every two groups (P <0.05). There was a positive correlation between RDW and LVEDD (r = 0.759, P <0.01) and a negative correlation with LVEF (r = -0.743, P <0.01). Conclusion: RDW is a sensitive index to reflect the impaired cardiac function, and has obvious correlation with cardiac function state and left ventricular remodeling. The detection of RDW can evaluate patients with different degrees of CHF, guide the treatment of CHF and evaluate the prognosis Important clinical value.