摘要
目的评价平均红细胞分布宽度(red cell distribution width,RDW)对心力衰竭患者住院预后的预测价值。方法对286例慢性心力衰竭患者进行回顾性分析,依据1周内平均RDW水平分为<13.6、13.6~15.0、≥15.0三组。比较其临床特征、住院治疗经过和主要心脏事件及死亡的发生率;采用logistic回归对住院死亡的相关危险因素进行分析;通过接收者工作特征(ROC)曲线下面积评估平均红细胞分布宽度对住院死亡的预测价值。结果三组患者在年龄、性别、吸烟史、心力衰竭病因分布等方面无统计学差异(P>0.05)。三组患者左心室射血分数分别为(58.34±10.21)%、(53.68±12.80)%、(49.02±13.12)%,存在统计学差异;随着平均RDW升高,心力衰竭恶化、恶性心律失常、住院病死率明显增加(P<0.05)。多因素logistic分析显示平均红细胞分布宽度是住院死亡的独立危险因素(OR=1.43,95%CI:1.04~2.12;P=0.038),其预测住院死亡的ROC曲线下面积为0.780,而单次的入院时RDW预测住院死亡的ROC曲线下面积为0.690。结论平均红细胞分布宽度是慢性心力衰竭患者住院死亡的独立危险因素,其对心力衰竭患者住院死亡的预测价值高于单次的红细胞分布宽度值。
Objective To evaluate the impact of mean red cell distribution width(RDW) on clinical outcomes in patients with chronic heart failure(CHF). Methods The data of 286 patients hospitalized with CHF were collected from the database of Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine. Patients were classified into 3 groups according to the mean RDW within a week after admission:<13.6,13.6~15.0,≥15.0. Clinical characteristics,therapeutic approaches and the incidence of major adverse cardiac events were compared. Risk factors for hospital mortality were analyzed by multivariate logistic regression analysis. Receiver-operator characteristic(ROC) curve was drawn to assess the power of mean RDW on predicting inhospital death. Results There were no significant differences in age,sex,smoking history and the causes of CHF among the 3 groups. Higher mean RDW levels were associated with increased risk of reduced LVEF,worsening heart failure,and malignant arrhythmias. Multivariate logistic regression analysis showed that mean RDW was an independent risk factor for in-hospital mortality(OR =1.43,95% CI:1.04 ~2.12;P =0.038). Mean RDW had the higher area under the ROC curve than that in single admission RDW(0.780 vs 0.690). Conclusion Mean RDW is an independent predictor for in-hospital motality in patients with CHF,which is superior to admission RDW based on single measurement in predicting in-hosptial mortality.
出处
《实验与检验医学》
CAS
2017年第6期830-832,835,共4页
Experimental and Laboratory Medicine
基金
福建省中医药科研项目计划(2017FJZYZY104)
关键词
慢性心力衰竭
红细胞分布宽度
预后
Chronic heart failure
Red cell distribution width
Clinical outcomes
