心力衰竭患者外周血RDW 和NT-pro-BNP 联合检测对临床诊断及分级的相关性研究

目的　探讨心力衰竭(heart failure,HF) 患者外周血红细胞体积分布宽度（red blood cell distribution width, RDW）和N 末端B 型脑钠肽前体（NT-pro-BNP）联合检测对HF 临床诊断及分级的相关性研究。方法　选择80 例HF 确诊患者和100 例健康体检者，采用Sysmex 全自动血细胞分析仪进行全血RDW 检测分析；采用电化学发光法检测血 清NT-pro-BNP 水平，运用SPSS17.0 软件对结果进行数据分析。结果　HF 确诊患者血中RDW 和NT-pro-BNP 的水平 明显高于健康对照者，差异有统计学意义（P ＜ 0.05）；NYHA 分级Ⅳ级患者血中RDW 和NT-pro-BNP 的水平显著高 于NYHA 分级Ⅰ～Ⅱ级和Ⅲ级患者，其差异具有统计学意义（P ＜ 0.05）。NYHA 分级Ⅲ级患者血中RDW 和NT-pro- BNP 的水平显著高于NYHA 分级Ⅰ～Ⅱ级患者，其差异具有统计学意义（P ＜ 0.05）。三组不同NYHA 分级HF 患者 血中NT-pro-BNP 和RDW 水平呈正相关关系（r = 0.554，P=0.01）；Pearson 相关分析显示RDW 与NT-pro-BNP 水平 呈正相关（r = 0.554，P = 0.01）。结论　RDW 和NT-pro-BNP 水平的联合检测可提高HF 的临床快速诊断率，为HF 诊 断、病程判断和预后提供诊断依据。

Correlation Study on the Combined Detection of RDW and NT-Pro-BNP in Patients with Heart Failure to Clinical Diagnosis and Grading

Objective　To investigate the combined detection of red blood cell volume distribution width (RDW) and N-terminal B-type brain natriuretic peptide precurso (NT-pro-BNP) in patients with heart failure(HF) to clinical diagnosis and grading. Methods　80 patients with heart failure and 100 healthy people were selected to detect RDW in whole blood by Sysmex automatic hematology analyzer, and NT-Pro-BNP in serum was detected by electrochemiluminescence.SPSS17.0 software was used to analyze the data. Results　The levels of RDW and NT-pro-BNP in patients with heart failure were significantly higher than those in healthy controls, and the difference was statistically significant (P<0.05).The levels of RDW and NT-pro- BNP in patients with NYHA grade Ⅳ were significantly higher than those of patients with NYHA grade Ⅰ～Ⅱ and Ⅲ，and the difference was statistically significant (P<0.05). The levels of RDW and NT-pro-BNP in patients with NYHA grade Ⅲ were significantly higher than those of patients with NYHA grade Ⅰ～Ⅱ，and the difference was statistically significant (P<0.05). There was a positive correlation between NT-pro-BNP and RDW levels in three groups of HF patients with different NYHA grades (r = 0.554, P = 0.01). Pearson correlation analysis showed that RDW was positively correlated with NT-pro-BNP (r = 0.554, P = 0.01). Conclusion　The combined detection of RDW and NT pro-BNP can improve the clinical diagnosis rate of HF and provide the diagnosis basis for HF diagnosis, course judgment and prognosis.