红细胞分布宽度对老年慢性心力衰竭患者预后的影响研究

摘要

Objective To explore the impact of red cell distribution width ( RDW ) to prognosis of elderly chronic heart failure ( CHF ) patients. Methods Totally 60 CHF patients were, according to the grades of cardiac function of New York Heart Association ( NYHA ), divided into three groups: NY Ⅱ ( n =20 ), NY Ⅲ ( n = 19 ) and NY Ⅳ ( n =21 ). The levels of RDW and serum NT - proBNP were compared among the 3 groups. And then the patients were again divided as normal RDW group ( n = 42 ) and abnormal RDW group ( n = 18 ), and the incidence of cardiac events was compared between the two groups. Results The difference in RDW showed significant among the 3 groups ( P < 0. 05 ), and so did between each two groups ( P <0. 05 ). The difference in NT - proBNP level showed significant among the 3 groups ( P < 0. 05 ), and so did between each two groups ( P < 0. 05 ). In the abnormal RDW group there 6 ( 33. 3% ) patients who got malignant arrhythmia, 8 (44.4% ) with repeated heart failure, and 3 ( 16.7% ) who died; while in normal RDW group there were respectively 1 ( 2. 4% ), 2(4. 8% ) and 1(2. 4% ). The incidence of cardiac events was significant higher in abnormal RDW group that in normal RDW group ( P < 0. 05 ). Conclusion The increase of serum RDW may associate with the severity of cardiac function in elderly CHF patients. The patients with increased RDW get higher incidence of cardiac events, with a unfavorable prognosis.%目的 探讨红细胞分布宽度(RDW)对老年慢性心力衰竭患者预后的影响.方法 选择60例老年慢性心力衰竭患者,按照纽约心脏病学会(NYHA)心功能分级标准分为心功能Ⅱ级20例、心功能Ⅲ级19例、心功能Ⅳ级21例,比较3组间RDW和血浆N-末端原脑利钠肽(NT-proBNP)的水平.再根据RDW分为RDW正常组42例和异常组18例,比较两组间心脏事件的发生率.结果 不同心功能级别的慢性心力衰竭患者RDW间差异有统计学意义(P＜0.05),组间两两比较差异均有统计学意义(P＜0.05);不同心功能级别的慢性心力衰竭患者NT-proBNP水平间差异有统计学意义(P＜0.05),组间两两比较差异均有统计学意义(P＜0.05).RDW异常组发生恶性心律失常6例(33.3%),心力衰竭反复或加重8例(44.4%),死亡3例(16.7%);RDW正常组发生恶性心律失常1例(2.4%),心力衰竭反复或加重2例(4.8%),死亡1例(2.4%),RDW异常组的心脏事件发生率高于RDW正常组,差异有统计学意义(P＜0.05).结论 RDW升高可能与老年慢性心力衰竭患者的心功能严重程度有关;RDW升高的老年慢性心力衰竭患者的心脏事件发生率高,预后不良.