冠心病患者血BNP、CRP及RDW的测定及临床意义

目的 了解RDW与BNP、RDW与CRP的相互关系,为冠心病高水平的RDW与增高的死亡率之间的关系提供一个可能的机制.方法 抽血检测了113例实行了导管插入术的CAD患者的血浆BNP和hs-CRP、RDW来源于病史单记录.结果 血浆BNP（r=0.21,P＜0.01）与RDW相关,而CRP（r=0.04,P＞0.05）与RDW 没有相关性;而将影响BNP的因素包括年龄、性别、体重指数、肾小球率过滤、血红蛋白及BNP的血液动力决定因素（增高的左心室舒张末期压、缓慢的左心室舒张压）用混交设计的方式去除后,结果表明BNP（r2=0.058,P＜0.001）能够独立的预警RDW.结论 冠心病患者的增高的BNP与增高的RDW是独立相关的,神经元介质激活也许是联系RDW增高与临床预后不良的一种可能机制.

The clinical significaion of detemination blood b -type natriurefic peptide, c - reafive protein and red distribution width

Objective To investigate the correlations between B - type natriuretic peptide （BNP） and c - reactive protein （CRP）and red distribution width（RDW）, then provide a potential mechanistic link between higher RDW and increased mortality in patients with heart failure and coronary artery disease （ CAD）. Methods To detect plasma BNP and Hs - CRP in 113 patients performed cardiac catheterization for the evaluation of CAD, RDW were obtained from case history re- cords. Results Plasm BNP（ r = 0.21, P 〈 0.01 ） but not hs - CRP（ r ~ 0.04, P 〉 0.05 ） levels correlated with RDW ; after ad- justment for potential confounders including age, gender, body mass index, glomerular filtration rate, hemoglobin, and known hemodynamic determinants of BNP （ elevated left ventricular end - diastolic pressure, slow left ventricular relaxation ）, RDW was independently predicted by BNP（ r2 = 0. 058, P 〈 0. 001 ）. Conclusion Elevated BNP are independently associated with higher RDW in patients with CAD. Neurohumoral activation may be a mechanistic link between increased RDW and adverse clinical outcomes in this patients.