慢性心力衰竭患者红细胞分布宽度与微量白蛋白尿的相关性研究

目的 观察慢性心力衰竭 （CHF） 患者红细胞分布宽度 （RDW） 与微量白蛋白尿 （MAU） 的变化， 并探讨它们和心功能分级的关系。方法 190 例 CHF 患者按照 NYHA 心功能分级标准分为 NYHAⅡ级 (轻度组)、 NYHAⅢ级 (中度组)及 NYHAⅣ级 (重度组)。同期正常体检者共 100 例为对照组。比较 4 组 MAU 与尿肌酐 （Scr） 比值 （UACR）、 RDW、 Scr、 血红蛋白 （Hb）、 B 型尿钠钛 （BNP）、 左室射血分数 （LVEF） 水平差异,分析 UACR、 RDW、 Scr、 Hb、 BNP、 LVEF 之间的相关性。结果 慢性心衰各亚组 RDW 、 Scr、 BNP、 超敏 C 反应蛋白 （hsCRP）、 左室舒张末期内径 （LVEDd）、 左室质量 （LVM）、 左室质量指数 （LVMI）、 UACR 均高于对照组， 且随着轻、 中、 重度组心功能分级增高依次增高， Hb、 LVEF 随心功能分级增高依次降低 （均 P < 0.05）。UACR、 RDW 随着心功能分级增高呈逐渐增高的趋势 (P < 0.05)。两者与 BNP 均呈正相关,与 LVEF、 Hb 呈负相关,两者之间呈正相关(均 P < 0.05)。结论 UACR、 RDW 与心功能分级有关， RDW、 MAU 评估可以用于 CHF 患者的预后评价。

Study on the correlation between red cell distribution width and microalbuminuria in patients with chronic heart failure

Objective To observe changes of red blood cell distribution width (RDW) and trace albumin urine (MAU) in patients with chronic heart failure (CHF) and to explore the relationship between them and cardiac function classification. Methods A total of 190 patients with CHF were divided into mild group (NYHA grade II), moderate group (NYHA grade Ⅲ) and severe group (NYHA grade Ⅳ), according to the grade of cardiac function. A total of 100 subjects with normal physi? cal examination during the same period were selected as the control group. The changes of MAU, urinary creatinine (Scr) ra? tio (UACR), RDW, Scr, hemoglobin (Hb), type B urine sodium titanium (BNP) and left ventricular ejection fraction (LVEF)were compared between four groups. The correlation between UACR, RDW, Scr, Hb, BNP and LVEF were analyzed. Re? sults The levels of RDW, Scr, BNP, hypersensitive C-reactive protein (hsCRP), LVEDd, LVM, LVMI and UACR were sig? nificantly higher in chronic heart failure group than those of control, showing a trend of increase gradually with the rising of heart function classification (P < 0.05). The values of Hb and LVEF showed a gradually decreasing trend with the increased heart function classification (P < 0.05). The values of UACR and RDW showed a gradually increasing trend with the in? creased heart function classification (P < 0.05). There was a positive correlation between UACR and RDW, and both had a positive correlation with BNP, and a negative correlation with LVEF and Hb(P < 0.05). Conclusion RDW and MAU are re? lated to the cardiac function classification, and both can be used for the evaluation of the prognosis in patients with CHF.