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1.
红细胞分布宽度(RDW)与炎症、冠状动脉病变的严重程度、冠状动脉的不稳定性有一定的相关性,能够预测冠心病(CHD)的预后。RDW的检测可能成为一种经济、简便易行用于CHD危险分层的方法。  相似文献   

2.
目的 探讨红细胞分布宽度(RDW)与冠心病合并慢性心力衰竭的相关性.方法 选取冠心病合并慢性心力衰竭患者142例,按红细胞分布宽度标准差(RDWSD)、红细胞分布宽度变异系数(RD-WCV)及左室射血分数(LVEF)分组观察血液指标及超声心动图指标.结果 按照RDWSD进行分组,高RDWSD组的N-末端脑钠肽前体(NT-proBNP)、尿素氮(BUN)、肌酐(CREA)、尿酸(UA)、舒张期左房直径(LAD)、左室舒张末期内径(LVEDD)、纽约心衰分级(NYHA)等指标均明显升高,均高于低RDWSD组(P<0.05);按照RDWCV进行分组,高RDWCV组的NT-proBNP、BUN、CREA、UA、LAD、LVEDD、NYHA等指标均明显升高,均高于低RDWCV组(P<0.05);按照LVEF进行分组,高LVEF组的NT-proBNP、BUN、CREA、UA、LAD、LVEDD、NYHA等指标均明显升高,均高于低LVEF组(P<0.05).结论 患者RDW升高,其NT-proB-NP、BUN、CREA、UA、LAD、LVEDD、NYHA等指标同时升高,NT-proBNP及NYHA心功能分级是国际公认的评价心功能的指标,RDW水平作为一个入院患者的常规检查指标,不仅可以作为心力衰竭患者的预后指标,也可作为丰富心力衰竭临床诊断的一个客观指标.  相似文献   

3.
红细胞分布宽度与急性心肌梗死患者并发症的关系   总被引:1,自引:1,他引:0  
目的 探讨红细胞分布宽度与急性心肌梗死患者住院期间并发症之间的关系,比较红细胞分布宽度与N末端脑钠肽前体、肌钙蛋白I和高敏C反应蛋白的相关性.方法 急性心肌梗死患者200例,根据住院期间有无发生并发症(新发症状性心功能衰竭、心律失常、心源性休克)分为心肌梗死并发症组(n=145)和单纯心肌梗死组(n=55);根据入院时红细胞分布宽度水平四分位分组(≤12.8%、12.9%~13.8%、13.9%~14.7%和≥14.8%,每组各50例),应用Logistic回归计算不同红细胞分布宽度水平并发症发生风险的优势比;Spearman等级相关比较红细胞分布宽度与N末端脑钠肽前体、肌钙蛋白I和高敏C反应蛋白的相关性.结果 心肌梗死并发症组红细胞分布宽度水平显著高于单纯心肌梗死组(14.50%±0.97%比12.90%±0.85%,P<0.05).急性心肌梗死患者红细胞分布宽度水平与并发症发生风险之间存在正相关,校正年龄、糖尿病、估算肾小球滤过率、左心室舒张期末内径、左心室射血分数、血浆N末端脑钠肽前体、肌钙蛋白I和高敏C反应蛋白以后,红细胞分布宽度水平最高四分位数患者发生并发症的风险是最低四分位数患者的1.96倍(95%可信区间为1.34~2.79,P<0.05).红细胞分布宽度与血浆N末端脑钠肽前体、肌钙蛋白I和高敏C反应蛋白的相关性逐次减弱(秩相关系数分别为0.31、0.29和0.21,P均<0.05).结论 红细胞分布宽度与急性心肌梗死患者并发症及N末端脑钠肽前体、肌钙蛋白I密切相关.  相似文献   

4.
慢性心力衰竭患者中红细胞分布宽度与心功能的关系   总被引:2,自引:0,他引:2  
目的:了解慢性心力衰竭(CHF) 患者红细胞分布宽度(red cell distribution width, RDW)与NYHA心功能分级之间的关系.方法:对688例CHF患者行临床、实验室检查和心脏超声检查,比较心功能Ⅱ、Ⅲ、Ⅳ级患者的左室射血分数、左室舒张末期内径、RDW及生化指标;随访12~18(平均15)个月,观察终点为全因死亡,比较RDW正常者和RDW增高者的病死率.结果:RDW随着心功能分级增高呈逐渐增高的趋势,Ⅲ级组、Ⅳ级组较Ⅱ级组显著增高(P<0.01);RDW增高者较RDW正常者病死率更高,差异有统计学意义(P<0.01).结论:RDW增高与CHF患者的心功能分级有关,RDW增高可能使CHF患者的死亡危险性增高.  相似文献   

5.
目的明确红细胞体积分布宽度(RDW)与老年急性失代偿射血分数保留心力衰竭(HFpEF)患者1年内预后的关系。方法入选2013年6月至2015年6月在首都医科大学附属北京友谊医院医疗保健中心心血管病房住院的125例急性失代偿HFpEF老年患者(年龄≥65岁),记录基本情况、合并疾病、用药情况,检测生化指标、超声心动图指标,检测并记录入院当日静脉血RDW。随访1年,根据1年内有无心力衰竭相关不良终点事件(心力衰竭死亡或心力衰竭再住院)分为事件组(n=38)与对照组(n=87),比较2组间各指标的差异。并根据RDW四分位区间进行分组,比较4组间临床特点及终点事件的差异。采用SPSS 16.0软件进行统计分析。应用logistic回归分析急性失代偿HFpEF相关不良预后的独立危险因素。应用受试者工作特征(ROC)曲线评价RDW预测心力衰竭不良结局的效应。结果事件组患者的RDW显著高于对照组[13.30%(12.45%,14.43%)vs 12.70%(11.50%,13.60%);P=0.022]。logistic回归显示,N末端B型利尿钠肽前体(NT-pro BNP)(OR=1.00,95%CI:1.00~1.00;P=0.010)、RDW(OR=1.19,95%CI:1.05~1.35;P=0.005)及应用袢利尿剂(OR=6.64,95%CI:2.10~20.94;P=0.001)与心力衰竭死亡和心力衰竭再住院的联合终点独立相关。随RDW水平增高,心力衰竭死亡及心力衰竭再住院联合终点事件发生率增高,差异有统计学意义(P0.05)。RDW预测联合终点的ROC曲线下面积为0.629(95%CI:0.521~0.737;P=0.022)。结论在老年急性失代偿HFpEF患者中,RDW与1年内心力衰竭死亡及心力衰竭再住院的不良预后独立相关。  相似文献   

6.
目的本研究旨在探讨脓毒症老年患者红细胞分布宽度与急性肾损伤(AKI)的关系。方法对2018年1月至2021年12月在福建省立医院的277例脓毒症老年患者的资料进行回顾性研究。比较急性肾损伤组和非急性肾损伤组老年患者的统计学数据、肾功能、炎症、全血细胞计数,采用多因素Logistic回归分析观察AKI相关的危险因素。结果脓毒症老年患者的AKI组与非AKI组相比,C反应蛋白(CRP)、红细胞分布宽度(RDW)和简化急性生理评分Ⅲ(SAPS3)水平均较高,而女性人数、血红蛋白浓度、血小板计数较低。多因素Logistic回归分析显示慢性肾脏病(CKD)(OR=3.624,95%CI 1.532~7.419;P<0.001)、血尿素氮(OR=1.347,95%CI 1.146~1.581,P=0.023)和红细胞分布宽度(RDW)(OR=1.864,95%CI 0.842~2.457;P=0.005)是脓毒症老年患者相关性急性肾损伤的独立危险因素。结论RDW作为一种选择性的危险因素,与老年患者脓毒症相关的急性肾损伤独立相关。因此,RDW是老年患者入院时脓毒症引起的急性肾损伤的预测因素。  相似文献   

7.
目的评价红细胞分布宽度(red blood cell distribution width,RDW)对置入药物洗脱支架(drug eluting stent,DES)的急性ST段抬高心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者预后的影响。方法连续入选急性STEMI患者484例,根据RDW值分为4组:A组(RDW<12.30%)、B组(12.30%≤RDW<12.90%)、C组(12.90%≤RDW<13.51%)和D组(RDW≥13.51%)。对4组患者临床资料、住院期间心血管事件以及长期预后随访进行比较。结果4组患者RDW、高血压、糖尿病、血糖、左心室射血分数(LVEF)、LVEF<40%、B型病变、C型病变比较,差异有统计学意义(P<0.05);住院期间死亡和主要不良心脑血管事件(main adverse cardiovascular and cerebrovascular events,MACCE)比较,差异有统计学意义(P=0.027和P=0.021),随访结果显示,4组患者全因死亡、心原性死亡、MACCE和支架内血栓发生率比较,差异有统计学意义(P=0.006、P=0.012、P=0.002和P=0.036);Cox回归分析显示,RDW显著提高全因死亡(HR1.577,95%CI 1.196~2.079,P=0.001)和MACCE(HR 1.456,95%CI 1.154~1.838,P=0.002)的发生率。D组的MACCE发生率高于其他3组(P<0.05)。结论对于置入DES的急性STEMI的非贫血患者,RDW升高是一个预测死亡和MACCE的独立危险因素。  相似文献   

8.
目的探讨外周血红细胞分布宽度(RDW)变化对老年慢性心力衰竭(CHF)患者预后的影响。方法收集2008年2月—2009年2月在我院住院的老年CHF患者173例,根据NYHA心功能分级分为两组(轻度心力衰竭组和重度心力衰竭组),比较两组RDW、血红蛋白(Hb)浓度、红细胞计数(RBC)及血细胞比容(Hct)的差异;根据RDW将患者分为RDW增高组和RDW正常组,比较两组患者的病死率。结果轻度心力衰竭组和重度心力衰竭组RDW、Hb、RBC及左室射血分数(LVEF)比较,差异均有统计学意义(P<0.05);两组患者Hct比较,差异无统计学意义(P>0.05)。RDW正常组病死率4.5%;RDW增高组病死率17.6%,两组患者病死率比较,差异有统计学意义(P<0.05)。结论 RDW值对老年CHF患者预后有一定预测价值,RDW增高的老年CHF患者预后较差。  相似文献   

9.
目的探讨红细胞体积分布宽度(RDW)与急性冠状动脉综合征(ACS)患者近期预后的关系。方法选择ACS患者1654例,根据基线RDW四分位数分为≤12.1%组419例、12.2%12.8%组364例、12.9%12.8%组364例、12.9%13.2%组463例和≥13.3%组408例。比较各组生化指标、1个月时心源性死亡、心力衰竭及再次心肌梗死发生率。评估RDW与1个月时恶性事件的关系。结果随着RDW逐步升高,心源性死亡、心力衰竭及再次心肌梗死发生率也逐步升高。logistic回归分析显示,RDW(OR=2.116,95%CI:1.42713.2%组463例和≥13.3%组408例。比较各组生化指标、1个月时心源性死亡、心力衰竭及再次心肌梗死发生率。评估RDW与1个月时恶性事件的关系。结果随着RDW逐步升高,心源性死亡、心力衰竭及再次心肌梗死发生率也逐步升高。logistic回归分析显示,RDW(OR=2.116,95%CI:1.4273.137,P=0.000)、B型钠尿肽>100ng/L(OR=3.510,95%CI:1.2213.137,P=0.000)、B型钠尿肽>100ng/L(OR=3.510,95%CI:1.22110.093,P=0.020)、LVEF<40%(OR=4.149,95%CI:2.00110.093,P=0.020)、LVEF<40%(OR=4.149,95%CI:2.0018.602,P=0.000)是ACS患者1个月时心源性死亡的独立危险因素。同时,RDW(OR=2.134,95%CI:1.6028.602,P=0.000)是ACS患者1个月时心源性死亡的独立危险因素。同时,RDW(OR=2.134,95%CI:1.6022.844,P=0.000)、年龄>65岁(OR=2.010,95%CI:1.1352.844,P=0.000)、年龄>65岁(OR=2.010,95%CI:1.1353.560,P=0.017)、糖尿病(OR=2.279,95%CI:1.3453.560,P=0.017)、糖尿病(OR=2.279,95%CI:1.3453.862,P=0.002)和LVEF<40%(OR=5.009,95%CI:2.6943.862,P=0.002)和LVEF<40%(OR=5.009,95%CI:2.6949.316,P=0.000)是1个月时心力衰竭及再次心肌梗死发生的独立危险因素。结论 RDW是ACS患者近期预后的独立危险因素。  相似文献   

10.
红细胞分布宽度(RDW)是反映外周血红细胞大小离散度的指标.RDW的增加提示心血管疾病的不良预后.RDW是急、慢性心衰,冠状动脉粥样硬化性心脏病,肺动脉高压以及脑卒中患者死亡或不良心血管事件发生的独立危险因素.RDW和N末端B型利钠肽原相比,有着类似甚至更好的预测价值.RDW影响心血管疾病患者预后的机制尚不清楚,可能综合了心血管疾病复杂的病理生理过程.  相似文献   

11.
Background Large-scale clinical research on the relationship between red blood cell distribution width (RDW) and intermediate-term prognosis in elderly patients with coronary artery disease (CAD) is lacking. Thus, this study investigated the effects of RDW on the intermediate-term mortality of elderly patients who underwent elective percutaneous coronary intervention (PCI). Methods Data from 1891 patients ≥ 65 years old underwent elective PCI from July 2009 to September 2011 were collected. Based on preoperative median RDW (12.3%), the patients were divided into two groups. The low RDW group (RDW < 12.3%) had 899 cases; the high RDW group (RDW ≥ 12.3%) had 992 cases. The all-cause mortality rates of the two groups were compared. Results Patients in the high RDW group were more likely to be female and accompanied with diabetes, had lower hemoglobin level. The mean follow-up period was 527 days. During follow-up, 61 patients died (3.2%). The postoperative mortality of the high RDW group was significantly higher than that of the low RDW group (4.3% vs. 2.0%, P = 0.004). After adjusting other factors, multivariate Cox regression analysis revealed that preoperative high RDW was significantly associated with postoperative all-cause mortality (hazard ratio: 2.301, 95% confidence interval: 1.106–4.785, P = 0.026). Conclusions Increased RDW was an independent predictor of the increased intermediate-term all-cause mortality in elderly CAD patients after elective PCI.  相似文献   

12.
红细胞分布宽度变化在冠心病患者中的临床价值   总被引:3,自引:0,他引:3  
目的 探讨红细胞分布宽度(RDW)与冠心病的相关性.方法 212例行冠状动脉造影的患者分为两组,以性别、年龄、心率、血压、空腹血糖、总胆固醇(Tc)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL- C)、低密度脂蛋白胆固醇(LDL-C)、红细胞计数、血红蛋白(Hb)、RDW、红细胞压积(Hct)等因素及冠脉评分进行多变...  相似文献   

13.
目的探讨社区获得性肺炎(CAP)患者的红细胞分布宽度(RDW)与其严重程度及预后的相关性。方法连续性选择2011年7月至2013年7月间,收住上海市嘉定区中心医院急诊科的CAP患者260例,根据RDW是否高于参考值的正常上限分为两组,分别为正常组RDW≦14.5%(n=208)和异常组RDW14.5%(n=52),比较两组患者的临床资料、实验值指标、PSI(pneumonia severity index,肺炎严重程度)评分分级及病死率的差异性;再根据PSI评分及预后,比较不同PSI级别和不同预后的RDW异常率的差异;采用Spearman相关分析对RDW及PSI评分进行相关分析。结果 RDW异常组发生重症率(46.2%vs 24.5%,P=0.003)、PSI IV-V级(53.8%vs 22.1%,P0.001)及病死率(15.4%vs 4.3%,P=0.009)显著高于正常组;RDW异常率随着PSI评分级别增高而增高(9.67%vs 16.13%vs 36.23%vs 60%,P0.001);死亡组发生RDW异常率(18.11%vs 47.06%,P=0.009)显著高于存活组;PSI评分与RDW呈显著正相关(r=0.210,P=0.001)。结论 CAP患者的RDW水平与其严重程度密切相关,RDW14.5%对其预后有重要的参考价值。  相似文献   

14.
目的 研究红细胞分布宽度(RDW)与青年ST段抬高型心肌梗死(STEMI)的关系.方法 入选2011-2012年在郑州大学第一附属医以及郑州大学附属洛阳中心医院接受急诊PCI的STEMI和冠脉造影正常的患者,分为4组.组1为100例青年STEMI患者,组2为100例老年STEMI患者,组3为50例冠脉正常的青年患者,组4为50例冠脉正常的老年患者.结果 组1患者的RDW高于组3[(14.5±1.3)%比(13.0±0.8)%,P<0.05],组2与组4RDW未见明显差异[(13.8±1.2)%比(13.6±0.8)%,P>0.05].多元Logistic回归分析发现,RDW为青年发生STEMI的独立危险因素(OR=1.408,P=0.001).结论 RDW增高与青年STEMI的发生可能具有相关性.  相似文献   

15.
Previous studies have shown an independent association between increased red cell distribution width (RDW) and mortality after acute myocardial infarction (AMI). However, evidence regarding the predictive significance of repeated measures of RDW in patients with AMI remains scarce. We aimed to investigate the association between the dynamic profile of RDW and in-hospital mortality in patients with AMI.This was a cross-sectional study. We extracted clinical data from the Medical Information Mart for Intensive Care IIIV1.4 database. Demographic data, vital signs, laboratory test data, and comorbidities were collected from the database. The clinical endpoint was in-hospital mortality. Cox proportional hazards models were used to evaluate the prognostic values of basic RDW, and the Kaplan–Meier method was used to plot survival curves. Subgroup analyses were performed to measure mortality across various subgroups. The repeated-measures data were compared using a generalized additive mixed model.In total, 3101eligible patients were included. In multivariate analysis, adjusted for age, sex, and ethnicity, RDW was a significant risk predictor of in-hospital mortality. Furthermore, after adjusting for more confounding factors, RDW remained a significant predictor of in-hospital mortality (tertile 3 vs tertile 1: hazard ratio 2.3; 95% confidence interval 1.39–4.01; P for trend <.05). The Kaplan–Meier curve for tertiles of RDW indicated that survival rates were highest when RDW was ≤13.2% and lowest when RDW was ≥14.2% after adjustment for age, sex, and ethnicity. During the intensive care unit stay, the RDW of nonsurvivors progressively increased until death occurred.Our findings showed that a higher RDW was associated with an increased risk of in-hospital mortality in patients with AMI.  相似文献   

16.
目的探讨红细胞分布宽度(RDW)对皮冠状动脉介入治疗(PCI)的2型糖尿病患者植入药物洗脱支架后发生支架内再狭窄(ISR)的预测价值。方法回顾性分析因不稳定型心绞痛入院、行PCI治疗植入药物洗脱支架的582例2型糖尿病患者的临床资料,其中292例在支架植入术后进行了冠状动脉造影随访,平均随访8个月。根据冠状动脉造影检查结果,将患者分为支架内再狭窄组(n=45)和非再狭窄组(n=247)。详细记录患者病史资料(年龄、性别、吸烟、既往病史)、实验室检查结果(RDW、C反应蛋白水平等),以及心脏彩超、冠状动脉造影等结果。结果 ISR组体质指数和吸烟史均比非ISR组高(P0.05)。ISR组RDW、C反应蛋白水平在入院和随访时均比非ISR组高。与非ISR组相比,ISR组的支架长度更长、直径更小。单因素分析显示,RDW与ISR呈正相关(P0.01)。多元回归分析显示,体质指数、吸烟、RDW、C反应蛋白、支架长度、支架直径是药物洗脱支架ISR的预测因子(P0.01)。结论糖尿病患者在具备同样的危险因素情况下,RDW对植入药物洗脱支架的不稳定型心绞痛患者发生ISR有预测作用,慢性炎症参与了ISR的形成过程。  相似文献   

17.
BACKGROUNDRed blood cell distribution width (RDW) is elevated in patients with cardiovascular disease (CVD).AIMTo determine RDW values and impact of CV and non-CV coexisting morbidities in elderly patients hospitalized with chronic CVD.METHODSThis prospective study included 204 consecutive elderly patients (age 77.5 [7.41] years, female 94 [46%], left ventricular ejection fraction 53.00% [37.50, 55.00]) hospitalized with chronic CVD at the Cardiology Department of Larissa University General Hospital (Larissa, Greece) from January 2019 to April 2019. Elderly patients were selected due to the high prevalence of coexisting morbidities in this patient population. Hospitalized patients with acute CVD (acute coronary syndromes, new-onset heart failure [HF], and acute pericarditis/myocarditis), primary isolated valvular heart disease, sepsis, and those with a history of blood transfusions or cancer were excluded. The evaluation of the patients within 24 h from admission included clinical examination, laboratory blood tests, and echocardiography.RESULTSThe most common cardiac morbidities were hypertension and coronary artery disease, with acutely decompensated chronic heart failure (ADCHF) and atrial fibrillation (AF) also frequently being present. The most common non-cardiac morbidities were anemia and chronic kidney disease followed by diabetes mellitus, chronic obstructive pulmonary disease, and sleep apnea. RDW was significantly elevated 15.48 (2.15); 121 (59.3%) of patients had RDW > 14.5% which represents the upper limit of normal in our institution. Factors associated with RDW in stepwise regression analysis were ADCHF (coefficient: 1.406; 95% confidence interval [CI]: 0.830-1.981; P < 0.001), AF (1.192; 0.673 to 1.711; P < 0.001), and anemia (0.806; 0.256 to 1.355; P = 0.004). ADCHF was the most significant factor associated with RDW. RDW was on average 1.41 higher for patients with than without ADCHF, 1.19 higher for patients with than without AF, and 0.81 higher for patients with than without anemia. When patients were grouped based on the presence or absence of anemia, ADCHF and AF, heart rate was not increased in those with anemia but was significantly increased in those with ADCHF or AF.CONCLUSIONRDW was elevated in elderly hospitalized patients with chronic CVD. Factors associated with RDW were anemia and CV factors associated with elevated heart rate (ADCHF, AF), suggesting sympathetic overactivity.  相似文献   

18.
The red blood cell distribution width(RDW) is a simple, rapid, inexpensive and straightforward hematological parameter, reflecting the degree of anisocytosis in vivo. The currently available scientific evidence suggests that RDW assessment not only predicts the risk of adverse outcomes(cardiovascular and all-cause mortality, hospitalization for acute decompensation or worsened left ventricular function) in patients with acute and chronic heart failure(HF), but is also a significant and independent predictor of developing HF in patients free of this condition. Regarding the biological interplay between impaired hematopoiesis and cardiac dysfunction, many of the different conditions associated with increased heterogeneity of erythrocyte volume(i.e., ageing, inflammation, oxidative stress, nutritional deficiencies and impaired renal function), may be concomitantly present in patients with HF, whilst anisocytosis may also directly contribute to the development and worsening of HF. In conclusion, the longitudinal assessment of RDW changes over time may be considered an efficient measure to help predicting the risk of both development and progression of HF.  相似文献   

19.
目的冠心病的临床特征具有明显的性别差异,既往研究证实红细胞分布宽度(RDW)与冠心病发生与发展有一定关系。本文探讨RDW与冠心病相关性的性别差异。方法连续收集因胸痛疑诊冠心病的患者674例,根据冠状动脉造影(CAG)结果分为冠心病组499例(男性352例,女性147例)与对照纰175例(男性89例,女性86例)。分析冠心病传统危险因素在不同性别的差异,探计RDW在不同性别冠心痛患者中的分布情况。结果不同性别总体的基线资料比较中,年龄、吸烟史、家族史、血红蛋白水平有性别差异(P〈0.05),男女两组的RDW无明显差异(P〉0.05)。不同性别的冠心病组与对照组相比,女性冠心病组与女性对照组相比,RDW显著升高[(12.9±0.7)%vs(126±0.6)%,P=0.001],男性冠心病组与男性对照组相比,RDW无统计学差异[(13.0±0.8)%vs(12.8±1.0)%,P=0.144]。女性冠心病患者多因素logistic回归分析显示,年龄和RDW是女性冠心病患者的独立预测因素(OR=1.07,95%CI:1.03-1.10,P〈0.001;OR=203,95%CI:1.28-3.23,P〈0.01)。女性RDW的ROC曲线下面积(AUC)=0.63,95%CI:0.56-0.70,RDW界值为12.75%,敏感性为57.1%,特异性为66.3%。结论RDW与冠心病之相关性存在性别差异,是女性冠心病的独立预测因素之一。  相似文献   

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