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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
黄樱硕,黄蔚,张侃,王倩倩,邢云利,白丽,孙颖.红细胞体积分布宽度与老年急性失代偿射血分数保留心力衰竭预后的关系[J].中华老年多器官疾病杂志,2018,17(3):172~177
红细胞体积分布宽度与老年急性失代偿射血分数保留心力衰竭预后的关系
Correlation of red cell distribution width with prognosis of acute decompensated heart failure with preserved ejection fraction in the elderly
投稿时间:2017-08-05  修订日期:2017-09-12
DOI:10.11915/j.issn.1671-5403.2018.03.038
中文关键词:  老年人;心力衰竭;红细胞体积分布宽度
英文关键词:aged; heart failure; red cell distribution width
基金项目:北京市优秀人才青年骨干项目(2014000021469G265);首都医科大学附属北京友谊医院科研启动基金(yyqdkt2015-26)
作者单位E-mail
黄樱硕 首都医科大学附属北京友谊医院医疗保健中心心血管内科,北京100050  
黄蔚 首都医科大学附属北京友谊医院医疗保健中心心血管内科,北京100050  
张侃 首都医科大学附属北京友谊医院医疗保健中心心血管内科,北京100050  
王倩倩 首都医科大学附属北京友谊医院医疗保健中心心血管内科,北京100050  
邢云利 首都医科大学附属北京友谊医院医疗保健中心心血管内科,北京100050  
白丽 首都医科大学附属北京友谊医院医疗保健中心心血管内科,北京100050  
孙颖 首都医科大学附属北京友谊医院医疗保健中心心血管内科,北京100050 ysun15@163.com 
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中文摘要:
      目的 明确红细胞体积分布宽度(RDW)与老年急性失代偿射血分数保留心力衰竭(HFpEF)患者1年内预后的关系。方法 入选2013年6月至2015年6月在首都医科大学附属北京友谊医院医疗保健中心心血管病房住院的125例急性失代偿HFpEF老年患者(年龄≥65岁),记录基本情况、合并疾病、用药情况,检测生化指标、超声心动图指标,检测并记录入院当日静脉血RDW。随访1年,根据1年内有无心力衰竭相关不良终点事件(心力衰竭死亡或心力衰竭再住院)分为事件组(n=38)与对照组(n=87),比较2组间各指标的差异。并根据RDW四分位区间进行分组,比较4组间临床特点及终点事件的差异。采用SPSS 16.0软件进行统计分析。应用logistic回归分析急性失代偿HFpEF相关不良预后的独立危险因素。应用受试者工作特征(ROC)曲线评价RDW预测心力衰竭不良结局的效应。结果 事件组患者的RDW显著高于对照组[13.30%(12.45%,14.43%) vs 12.70%(11.50%,13.60%);P=0.022]。logistic回归显示,N末端B型利尿钠肽前体(NT-proBNP)(OR=1.00,95%CI:1.00~1.00;P=0.010)、RDW(OR=1.19,95%CI:1.05~1.35;P=0.005)及应用袢利尿剂(OR=6.64,95%CI:2.10~20.94;P=0.001)与心力衰竭死亡和心力衰竭再住院的联合终点独立相关。随RDW水平增高,心力衰竭死亡及心力衰竭再住院联合终点事件发生率增高,差异有统计学意义(P<0.05)。RDW预测联合终点的ROC曲线下面积为0.629(95%CI:0.521~0.737;P=0.022)。结论 在老年急性失代偿HFpEF患者中,RDW与1年内心力衰竭死亡及心力衰竭再住院的不良预后独立相关。
英文摘要:
      Objective To investigate the relationship of red cell distribution width (RDW) with 1-year outcomes in the elderly with acute decompensated heart failure with preserved ejection fraction (HFpEF). Methods A total of 125 consecutive patients (≥65 years old) admitted in the cardiovascular ward of health care center of our hosipatal from June 2013 to June 2015 were enrolled in this study. Their baseline data, comorbidities, drug uses, laboratory results and echocardiographic parameters, and RDW at admission were collected and recorded. After 1 year of follow-up, the patients were divided into events group (n=38) and control group (n=87) according to whether there was cardiac-related adverse events (composite endpoint of heart failure death and heart failure re-admission). Based on the interquartile range (IQR) of RDW, the patients were also assigned into 4 groups, the clinical data and endpoint events were compared among the 4 groups. SPSS statistics 16.0 was used to perform the statistical analysis. Logistic regression analysis was used to determine the independent risk factors of acute decompensated HFpEF. Receiver operating characteristic (ROC) curve was plotted to determine cut-off value of RDW to predict adverse outcomes of heart failure. Results Compared with the control group, the RDW value was significantly higher in the events group [13.30% (12.45%, 14.43%) vs 12.70% (11.50%, 13.60%);P=0.022]. Logistic regression analysis showed N-terminal pro-B-type natriuretic peptide (NT-proBNP) (OR=1.00,5%CI:1.00-1.00; P=0.010), RDW (OR=1.19,5%CI:1.05-1.35; P=0.005) and use of loop diuretics therapy (OR=6.64,5%CI:2.10-20.94; P=0.001) were independently correlated with composite endpoint of heart failure death and heart failure re-admission. With the increase of RDW, the incidences of endpoint events were elevated (P<0.05). The area under ROC curve was 0.629 in predicting composite endpoints (95%CI:0.521-0.737; P=0.022). Conclusion RDW is independently correlated with 1-year composite outcome of heart failure death and heart failure re-admission in the elderly patients with acute decompensated HFpEF.
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