红细胞体积分布宽度与心衰患者血浆N末端脑钠肽关系的研究

目的观察心衰患者（HF）红细胞体积分布宽度（RDW）与N末端脑钠肽（NT-proBNP）的关系,从而探讨RDW作为maker评价心衰的价值。方法选择2008年10月至2010年3月我院心力衰竭病房明确诊断心衰的患者464例,男312例,女152例。平均年龄60±12岁。用自动化全血细胞分析仪测患者RDW,用酶联免疫吸附分析（ELISA）法测定NT-proBNP浓度,并进行对比分析。结果 464例心衰患者中有218例RDW值〉15.0%,异常率为47.0%（218/464）;RDW按四分位数分四组,比较各组间NT-proBNP浓度差异,结果显示NT-proBNP浓度在各组段之间均有显著差异（P〈0.001）,其中高于P75组段的NT-proBNP浓度（3455fmol/ml）是P25组段NT-proBNP浓度（646 fmol/ml）的五倍以上。RDW第3四分位数P75的NT-proBNP浓度（1902 fmol/ml）是第2四分位数P50的NT-proBNP浓度（985 fmol/ml）的两倍;采用统计学Spearman相关分析,RDW与NT-proBNP高度相关（r=0.637,P〈0.001）。结论心衰患者RDW水平升高与体内NT-proBNP浓度升高呈正相关,提示RDW可作为诊断心衰及判断预后的maker,是NT-proBNP的有力补充。

The study of Red cell distribution width and NT-proBNP levels in heart failue Patients

Objective To investigate red cell distribution width（RDW） in patients with heart failure（HF） and relationship between RDW and N-terminal brain natriuretic peptide（NT-proBNP）.Methods We select 464 Patients with HF between October 2008 and March 2010.Red cell distribution width was automatically calculated by an XE 1800 auto-analyser,The NT-proBNP measured by ELESA.Results The positive of the RDW for HF was 47.0%（218/464）;In a model using quartiles of RDW,there was significant statistical differences between each quartiles with the levels of NT-proBNP（P0.05）,the levels of NT-proBNP increased 5-fold from the lowest to the highest quartile;and increased 2-fold from the second quartile to the third quartile.Spearman analysis showed that NT-proBNP levels positively correlated with RDW（r=0.637,P0.001）.Conclusion RDW is a readily available test in the HF-population with positive correlation to NT-proBNP.The detection of RDW is useful for the diagnosis of HF;RDW may be helpful for diagnosis and prognosis of HF.