Ⅱ型心肾综合征患者不同肾功能分期的红细胞参数比较

摘要

Objective To investigate the levels of inflammation and anemia in patients of Type Ⅱ cardio-renal syndrome.Methods Two hundred and nine cases of Type Ⅱ cardio-renal syndrome patients were divided into Chronic kidney disease CKD3 period group (129 cases),CKD4 period group (59 cases) and CKD5 period group (21 cases),88 cases of chronic heart failure (CHF) patients as CHF group,enrolled in Department of Cardiology,Guang'anmen Hospital from January 2009 to December 2009,and a total of 152 healthy people as healthy group were selected.The levels of red blood cell parameters in each group were examined.Results The comparison of levels of red blood cell count (RBC),hemoglobin (Hb),hematocrit (HCT):CKD3,CKD4,CKD5 groups were lower than healthy group,and CKD4,CKD5 groups were lower than CHF group,and CKD5 group was lower than CKD3 group,and the difference was significant (P ＜ 0.01).The levels of RBC and HCT in CHF group were lower than those of healthy group,and the difference was significant (P ＜ 0.01 or P＜ 0.05).The comparison of levels of red blood cell volume distribution width (RDW-CV):CHF,CKD3,CKD4,CKD5 groups werehigherthan healthy group,and CKD4 group washigher than CHF group,and the difference was significant (P ＜ 0.01 or P ＜ 0.05).Mean corpuscular hemoglobin concentration (MCHC),RDW-CV were positively correlated with Type Ⅱ cardio-renal syndrome (P ＜ 0.05).RBC,Hb,HCT,mean corpuscular volume (MCV),mean corpuscular hemoglobin (MCH) were negatively correlated with the Type Ⅱ cardio-renal syndrome (P ＜ 0.05).Conclusion The levels of inflammation and anemia in Type Ⅱ cardio-renal syndromepatientsare associated with red blood cell parameters,and may increase according to the reduction of cardiacfunction and renal function.%目的 比较Ⅱ型心肾综合征患者的红细胞参数,明确其与炎症和贫血状态的相关性.方法 选择2009年1月～2015年12月于广安门医院心内科住院的Ⅱ型心肾综合征患者209例,根据肾小球滤过率(GFR)分为慢性肾脏病(CKD)3期组(129例)、CKD4期组(59例)、CKD5期组(21例),单纯慢性心力衰竭(CHF)患者88例为CHF组.另选择健康者152例为健康组,检测各组的红细胞参数并统计比较.结果 各组红细胞(RBC)、血红蛋白(Hb)、血细胞比容(HCT)比较:CKD3～5期组低于健康组,CKD4～5期组低于CHF组,CKD5期组低于CKD3期组,差异均有统计学意义(P＜ 0.01),CKD5期组与CKD4期组比较,差异无统计学意义(P＞0.05).CHF组RBC、HCT低于健康组,差异有统计学意义(P＜ 0.05或P＜ 0.01).各组RDW-CV比较:CHF组、CKD3～5期组高于健康组,CKD4期组高于CHF组,差异有统计学意义(P＜ 0.05或P＜0.01).平均血红蛋白浓度(MCHC)、红细胞分布宽度变异系数(RDW-CV)与Ⅱ型心肾综合征发生呈显著正相关(P＜ 0.05);RBC、Hb、HCT、平均红细胞体积、平均血红蛋白量与Ⅱ型心肾综合征发生呈显著负相关(P＜0.05).结论 Ⅱ型心肾综合征患者炎症和贫血状态与红细胞参数相关,并且可能随心、肾功能降低而加重.