摘要
目的探讨红细胞分布宽度(RDW)在心力衰竭合并慢性阻塞性肺疾病(COPD)患者病情严重程度及预后中的应用价值。方法选取2017年6月至2019年6月河南科技大学第一附属医院收治的232例心力衰竭合并COPD患者,根据美国纽约心脏病协会(NYHA)心功能分级分为Ⅰ级组51例,Ⅱ级组60例,Ⅲ级组64例,Ⅳ级组57例,另选取同期收治的60例心力衰竭患者为对照组。根据232例心力衰竭合并COPD患者住院期间是否死亡分为生存组201例和死亡组31例。比较各组间RDW、左心室射血分数(LVEF)、N端脑钠肽前体(NT-proBNP)水平,分析RDW与心力衰竭合并COPD病情严重程度及预后的相关性。结果从对照组、Ⅰ级组、Ⅱ级组、Ⅲ级组到Ⅳ级组,RDW、NT-proBNP水平呈上升趋势,LVEF值呈下降趋势,且差异有统计学意义(P<0.05);RDW、NT-proBNP水平与心力衰竭合并COPD患者的病情严重程度呈正相关(r=0.793、0.847,P<0.05),LVEF值与心力衰竭合并COPD患者的病情严重程度呈负相关(r=-0.910,P<0.05);死亡组RDW、NT-proBNP水平高于生存组(P<0.05),LVEF低于生存组(P<0.05);经受试者工作特征曲线分析,RDW曲线下面积为0.866。结论 RDW与心力衰竭合并COPD患者病情严重程度呈正相关,可作为临床评估心力衰竭合并COPD患者预后的参考指标。
Objective To investigate the value of red cell distribution width(RDW)in predicting the severity and prognosis of patients with heart failure complicated by chronic obstructive pulmonary disease(COPD).Methods A total of 232 COPD patients with heart failure treated in the First Affiliated Hospital of Henan University of Science and Technology from June 2017 to June 2019 were selected.According to the New York Heart Association(NYHA)classification,the 232 patients were divided into group I(n=51),groupⅡ(n=60),groupⅢ(n=64),group IV(n=57).Meanwhile,another 60 COPD patients treated in the same period were set as control group.And according to prognosis during the hospitalization period,the 232 patients were divided into survival group(n=201)and death group(n=31).Various indexes were compared among the groups,including RDW,left ventricular ejection fraction(LVEF),and N-terminal pro-brain natriuretic peptide(NT-proBNP).Then the correlation of the RDW with the severity and prognosis of patients with heart failure complicated by COPD was analyzed.Results According to the order of control group,group I,groupⅡ,groupⅢand group IV,the RDW and NT-proBNP level showed an upward trend,and LVEF value showed a downward trend in the order(P<0.05).Levels of RDW and NT-proBNP were positively correlated with the severity of COPD patients with heart failure(r=0.793,0.847;P<0.05),and LVEF values were negatively correlated with the severity of COPD patients with heart failure(r=-0.910,P<0.05).The levels of RDW and NT-proBNP in death group were significantly higher than those in survival group(P<0.05),and LVEF was significantly lower than that in survival group(P<0.05).The area under the receiver operating characteristic curve of RDW was 0.866.Conclusions RDW is positively correlated with the severity of the disease in COPD patients with heart failure,which can be used as a reference index for clinical evaluation of the prognosis.
作者
刘威
李志娟
邢适颖
李春燕
Liu Wei;Li Zhijuan;Xing Shiying;Li Chunyan(Department of Cardiology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)
出处
《中国实用医刊》
2020年第11期19-22,共4页
Chinese Journal of Practical Medicine
基金
洛阳市科技计划医疗卫生科项目(1603002A-5)。
关键词
红细胞分布宽度
心力衰竭
慢性阻塞性肺疾病
病情程度
预后
Red cell distribution width
Heart failure
Chronic obstructive pulmonary disease
Severity
Prognosis
