糖尿病合并心力衰竭患者红细胞分布宽度与血清脑利钠肽水平的相关性

目的探讨糖尿病(DM)合并心力衰竭患者红细胞分布宽度(RDW)与血清脑利钠肽(BNP)水平的相关性。方法收集80例DM合并心力衰竭的患者作为观察组并选取年龄和性别相匹配的DM无心脏病史,心电图正常的患者80例作为对照组。分别对两组患者进行RDW与BNP的检测。结果观察组RDW明显高于对照组(P<0.05),并且观察组RDW与BNP水平呈相相关(r=0.768,P<0.01)。结论在DM患者中RDW可作为预测心力衰竭的一个指标。     

红细胞分布宽度和血清尿酸检测老年慢性心力衰竭患者预后的临床意义

目的探讨红细胞分布宽度(RDW)、血清尿酸对慢性心力衰竭(CHF)患者预后价值及相关性。方法收集2009年2月²012年2月住我院干部心脏内科的老年CHF患者322例作为病例组,按心功能分级(NYHA):心功能Ⅱ级110例,心功能Ⅲ级122例,心功能Ⅳ级90例,同时收集同期健康体检者150例作为对照组。2组晨起空腹采静脉血,检测治疗前后RDW、尿酸水平,并进行分析比较。结果病例组RDW、尿酸水平显著高于对照组,差异有统计学意义[(15.87±2.02)%vs(11.15±0.76)%,(467.83±77.88)μmol/L vs(219.90±50.65)μmol/L,P<0.05];心功能Ⅲ级患者RDW和尿酸水平与心功能Ⅱ级和心功能Ⅳ级比较,差异有统计学意义(P<0.05,P<0.01)。不同心功能患者治疗前后RDW和尿酸水平比较,差异有统计学意义(P<0.05)。结论 RDW、尿酸可能有助于判断心力衰竭治疗效果、心力衰竭严重程度及预后。     

收缩性和舒张性心力衰竭患者脑利钠肽水平的对比分析

目的：探讨收缩性和舒张性心力衰竭患者血浆脑利钠肽（BNP）水平的差异和收缩性心力衰竭患者脉压与BNP水平的关系。方法：2005年10月至2006年7月在天津医科大学总医院心内科住院患者34例分为两组：收缩性心力衰竭组患者22例，舒张性心力衰竭组患者12例。采取静脉血测定血浆BNP浓度，行超声心动图检查，测量血压，计算脉压。结果：收缩性心力衰竭组的血浆BNP水平、左心室舒张末期内径（LVEDd）比舒张性心力衰竭组的高（p〈0．05～0．001）。收缩性心力衰竭患者BNP水平与脉压、收缩压、左室射血分数（LVEF）呈显著负相关（分别r=-0．58，P〈0．01；r=-0．50，P〈0．05；r=-0．62，P〈0．01），与LVEDd、右心室舒张末期内径（RVEDd）呈正相关（分别r=0．55，P〈0．05；r=0．57，P〈0．05）。结论：收缩性心力衰竭患者血浆BNP水平高于舒张性心力衰竭患者，其血浆BNP水平升高与脉压降低有关。     

慢性心力衰竭患者中红细胞分布宽度与心功能的关系

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.     

心力衰竭患者红细胞分布宽度与甲状腺激素的相关性

红细胞分布宽度(RDW)对贫血的诊断及鉴别诊断有重要的意义〔1〕。近年来,RDW在心力衰竭、冠心病及糖尿病等疾病中的研究日益增多。Felker等〔2〕已证实,与LVEF、NYHA心功能分级和肾功能水平等慢性充血性心力衰竭预后因素相比,RDW与CHF的预后有更强的统计学关联。另外一方面,慢性     

非瓣膜病慢性心力衰竭患者红细胞分布宽度

红细胞分布宽度(RDW)是数字化测量血液循环中红细胞形态的可变性的一个指标,既往它的用处仅限于贫血的分类诊断。最近RDW作为影响慢性心力衰竭(CHF)进程正逐步被认识。坎地沙坦治疗心衰减少发病率和死亡率的评价研究(CHARM)和Duke数据库的资料显示RDW可作为心衰预后的     

红细胞分布宽度对老年急性肺栓塞患者近期预后的影响分析

目的探讨红细胞分布宽度(RDW)对老年急性肺栓塞患者近期预后的影响。方法回顾性分析我院81例老年急性肺栓塞患者临床资料,根据RDW水平分为3组,RDW低值组27例,RDW中值组27例,RDW高值组27例,比较3组患者住院死亡、休克发生率及其他血流动力学、实验室指标。结果随RDW水平升高,RDW低值组、RDW中值组和RDW高值组住院病死率、死亡和休克总发生率、N末端B型利钠肽前体水平明显增加(P<0.05)。Pearson相关分析显示,与死亡发生的相关因素是年龄、收缩压、心率、N末端B型利钠肽前体、肌钙蛋白I、RDW(P<0.05,P<0.01)。logistic多因素回归分析显示,年龄、收缩压、心率是住院死亡的独立影响因素(P<0.05,P<0.01)。结论老年急性肺栓塞患者RDW升高者住院死亡和休克的发生率增加。     

红细胞分布宽度在心力衰竭中应用的研究进展

红细胞分布宽度是反映周围红细胞体积大小变异性的参数。近年研究发现,红细胞分布宽度增高与急、慢性心力衰竭的严重程度与预后有关。这可为临床提供心力衰竭患者的危险度分层及判断预后的重要信息。但其根本机制尚待进一步探讨。     

红细胞分布宽度的变化对老年慢性心力衰竭患者预后的影响

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。     

红细胞分布宽度与慢性心力衰竭患者发生恶性心律失常的关系

目的研究红细胞分布宽度(RDW)与慢性心力衰竭(CHF)患者发生恶性心律失常的关系。方法据常规心电图及24 h动态心电图检查将115例CHF患者分为恶性心律失常组(n=47)和非恶性心律失常组(n=68),均行RDW、氨基末端B型利钠肽前体(NT-proBNP)检测,分析两组RDW及NT-pro BNP差异。结果恶性心律失常组RDW及NT-proBNP水平均高于非恶性心律失常组(P<0.01),以RDW≥15.3%且NT-proBNP≥3 250 pg/L为截点,预测CHF患者发生恶性心律失常的敏感度、特异度、阳性预测值、阴性预测值分别为47%、90%、76%、71%。结论 RDW水平升高与CHF患者发生恶性心律失常相关,联合NT-pro BNP对CHF患者发生恶性心律失常有一定的预测价值。     

Relationship between red cell distribution width and echocardiographic parameters in patients with diastolic heart failure

Red cell distribution width (RDW) was found to be a prognostic marker in heart failure patients. The aim of the study was to investigate the relationship between RDW and echocardiographic parameters in diastolic heart failure (DHF). Seventy-one consecutive DHF patients (26 men) and 50 controls (21 men) were included in the study. All of the study population underwent echocardiographic evaluation, and blood samples were obtained. RDW and N-terminal pro-B-type natriuretic peptide (NT-proBNP) values were significantly higher, whereas there was an increasing trend for high-sensitivity C-reactive protein levels in DHF patients than those in controls (p<0.001, p<0.001, and p=0.064, respectively). All of the echocardiographic parameters evaluating diastolic function were more deteriorated in the DHF group. Patients who had an RDW value greater than the cutoff point also had higher NT-proBNP levels, an elevated ratio of mitral peak velocity of early diastolic filling to early diastolic mitral annular velocity, and increased estimated pulmonary capillary wedge pressures by tissue Doppler parameters, but lower creatinine clearance (p<0.05 for all). According to the cutoff values calculated using receiver operating characteristic analysis, RDW>13.6% and NT-proBNP>125pg/mL have high diagnostic accuracy for predicting DHF. RDW values were increased in the DHF population. Our results suggest that the high RDW levels in patients with DHF may be related to increased neurohormonal activity, impaired renal functions, and elevated filling pressure, but not to increased inflammation.     

Red blood cell distribution width in elderly hospitalized patients with cardiovascular disease

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.     

Red blood cell distribution width in heart failure: A narrative review

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.     

舒张性心力衰竭与收缩性心力衰竭临床特征的比较

目的:探讨舒张性心力衰竭和收缩性心力衰竭患者临床特征的差异。方法:选择心力衰竭患者253例,其中舒张性心力衰竭118例,收缩性心力衰竭135例。登记患者的临床资料,分析各组患者临床特征的差异。所有患者均检测N末端脑钠尿肽前体(NT-proBNP)及高敏C反应蛋白(hs-CRP)。结果:舒张性心力衰竭和收缩性心力衰竭均以老年患者居多,前者以女性多见(56.8%),并发高血压病(81.4%)及心房颤动(26.3%)均高于于后者(前项P0.01,后项P0.05),并发冠心病(45.8%)少于后者(P0.01);两组NT-proBNP及hs-CRP均随着NYHA心功能分级增加而显著升高(P0.01),舒张性心力衰竭组NT-proBNP低于收缩性心力衰竭组(P0.01),但hs-CRP两组间差异无统计学意义。结论:与收缩性心力衰竭相比,舒张性心力衰竭于老年女性更多见,高血压病患病率及心房颤动发生率较高,NT-proBNP水平较低。