红细胞分布宽度预测慢性阻塞性肺疾病并发心力衰竭价值研究
摘要
目的:探讨红细胞分布宽度(RDW)检测在预测慢性阻塞性肺疾病(COPD)并发心力衰竭中的临床价值。方法:选择在本院住院的COPD急性加重期200例为观察组,根据6min步行距离和氨基末端脑钠肽前体(NT-proBNP)检测结果,将观察组分为COPD并发心力衰竭组(观察1组)107例和单纯COPD组(观察2组)93例。另选择同期在本院体检的健康者80例为对照组。收集所有入组病例的性别、年龄和体质指数等一般资料,以及血常规、血气分析、6min步行距离和NT-proBNP等检查结果。比较3组RDW、NT-proBNP、6min步行距离等指标。结果:观察1组RDW、NT-proBNP水平、血二氧化碳分压(PCO2)等指标,均显著或非常显著高于观察2组和对照组(P<0.05,P<0.01);观察2组上述指标又显著或非常显著高于对照组(P<0.05,P<0.01)。观察1组6min步行距离、血氧分压(PO2),均显著或非常显著低于观察2组和对照组(P<0.05,P<0.01);观察2组上述指标又显著或非常显著低于对照组(P<0.05,P<0.01)。3组白细胞(WPC)计数、血红蛋白(HB)水平差异不显著(P>0.05)。结论:RDW检测在预测COPD并发心力衰竭方面具有较高的临床价值。
引文
[1]Vestbo J,Hurd SS,AgustíAG,et al.Global strategy for the diagnoiss,management,and prevention of chronic obstructive pulmonary disease:GOLD executive summary[J].Am J Respir Crit Care Med,2013,187(4):347-365.
[2]Sincer I,Zorlu A,Yilmaz MB,et al.Relationship between red cell distribution width and right ventricular dysfunction in patients with chronic obstructive pulmonary disease[J].Heart Lung,2012,41(3):238-243.
[3]Tertemiz KC,Ozgen Alpaydin A,Sevinc C,et al.Could"red cell distribution width"predict COPD severity[J]?Rev Port Pneumol(2006),2016,22(4):196-201.
[4]顾鹏,陈建荣,陈令东,等.BNP、CRP和cTNI测定AECOPD患者危险分层及预后判断的临床价值[J].临床急诊杂志,2014,15(2):79-81.
[5]丁薇,赵伟,李杨瑞.心血管合并症对慢阻肺患者急性加重及病死率影响的1年随访观察[J].临床肺科杂志,2016,21(5):777-780.
[6]Fukuta H,Ohte N,Mukai S,et al.EleVated plasma levels of B type natriuretic peptide but not C-reactive protein are associationed with higher red cell distribution width in patient with coronary artery disease[J].Int Heart J,2009,50(3):301-312.
[7]MacGowan GA,Neely D,Peaston R,et al.Evaluation of HT-pro BNP to predict 0utcomes in advanced heaIt failure[J].Int J clin Pract,2010,64(7):892-899.
[8]杨妮,柯蕊,刘原.红细胞分布宽度在肺部疾病中的临床价值[J].国际呼吸杂志,2015,35(11):874-877.
[9]徐劲松,夏国际,王鹏,等.不同程度慢性阻塞性肺疾病患者的红细胞分布宽度[J].广东医学,2015,36(5):759-760.
[10]吴峰妹,黄建安.AECOPD患者血清PCT、CRP变化及临床意义[J].国际呼吸杂志,2014,34(8):581-584.
[11]Bircan A,Gokirmak M,Kilic O,et al.C-reactive protein levels inpatients with chronic obstructive pulmonary disease:Role of infection[J].Med Princ Pract,2008,17(3):202-208.
[12]Uysal OK,Duran M,Ozkan B,et al.Red cell disyribution width is associated with acute myocardial infarction in young patients[J].Cardiol J,2012,19(6):597-602.
[13]Jo YH,Kim K,Lee JH,et al.Red cell distribution width is a prognostic factor in severe sepsis and septic shock[J].Am J Emerg Med,2013,31(3):545-548.
[14]王飞,丁勇,姜婷婷,等.红细胞分布宽度对危重患者预后的评估价值[J].中华急诊医学杂志,2014,23(8):894-897.
[15]Zorlu A,Bektasoglu G,Guven FM,et al.Usefulness of admissionred cell distribution width as a predictor of early mortality in patients with acute pulmonary embolism[J].Am J Cardiol,2012,109(1):128-134.
[16]宋雨,杨媛华,王辰.红细胞分布宽度对慢性阻塞性肺疾病短期预后的预测价值[J].中国实用内科杂志,2015,35(3):239-241.
[17]陈思佳,王飞,胡善友,等.慢性阻塞性肺部疾病急性加重期患者的红细胞分布宽度与其30天预后的相关性[J].医学研究杂志,2015,44(10):80-82.
[18]李玉明,张丽霞,郭明日,等.N端脑利钠肽和红细胞分布宽度与慢性阻塞性肺疾病严重程度的相关性[J].中国慢性病预防与控制,2017,25(3):204-206.
[19]van Kimmenade RR,Mohammed AA,Uthamalingam S,et al.Red blood cell distribution width and 1-year mortality in acute heart failure[J].Eur J Heart Fail,2010,12(2):129-136.
[20]Seyhan EC,zgül MA,Tutar N,et al.Red blood cell distribution and survival in patients with chronic obstructive pulmonary disease[J].COPD,2013,10(4):416-424.
[21]Frhecz Z,Gombos T,Borgulya G,et al.Red cell distribution width in heart failure:Prediction of clinical events and relationship with markers of ineffectiveerythropoiesis,inflammation,renal function,and nutritional state[J].Am Heart J,2009,158(4):659-666.
[22]AL-Najjar Y,Goode KM,Zhang J,et al.Red cell distribution width:An inexpensive and powerful prognostic marker in heart failure[J].Eur J Heart Fail,2009,11(12):1155-1162.
[23]Allen LA,Felker GM,Mehra MR,et al.Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure[J].J Card Fail,2010,16(3):230-238.
[24]Ellis L,Hammers H,Pili R.Targeting tumor angiogenesis with histone deacetylase inhibitors[J].Cancer Lett,2009,280(2):145-153.
[25]王金艳,洪波,孙珍贵,等.红细胞分布宽度与慢性阻塞性肺部疾病继发肺动脉高压的相关性研究[J].国际呼吸杂志,2014,34(17):1301-1303.
[26]Rhodes CJ,Wharton J,Howard LS,et al.Red cell distribution width outperforms other potential circulating biomarkers in predicting survival in idiopathic pulmonary arterial hypertension[J].Heart,2011,97(13):1054-1060.
[2]Sincer I,Zorlu A,Yilmaz MB,et al.Relationship between red cell distribution width and right ventricular dysfunction in patients with chronic obstructive pulmonary disease[J].Heart Lung,2012,41(3):238-243.
[3]Tertemiz KC,Ozgen Alpaydin A,Sevinc C,et al.Could"red cell distribution width"predict COPD severity[J]?Rev Port Pneumol(2006),2016,22(4):196-201.
[4]顾鹏,陈建荣,陈令东,等.BNP、CRP和cTNI测定AECOPD患者危险分层及预后判断的临床价值[J].临床急诊杂志,2014,15(2):79-81.
[5]丁薇,赵伟,李杨瑞.心血管合并症对慢阻肺患者急性加重及病死率影响的1年随访观察[J].临床肺科杂志,2016,21(5):777-780.
[6]Fukuta H,Ohte N,Mukai S,et al.EleVated plasma levels of B type natriuretic peptide but not C-reactive protein are associationed with higher red cell distribution width in patient with coronary artery disease[J].Int Heart J,2009,50(3):301-312.
[7]MacGowan GA,Neely D,Peaston R,et al.Evaluation of HT-pro BNP to predict 0utcomes in advanced heaIt failure[J].Int J clin Pract,2010,64(7):892-899.
[8]杨妮,柯蕊,刘原.红细胞分布宽度在肺部疾病中的临床价值[J].国际呼吸杂志,2015,35(11):874-877.
[9]徐劲松,夏国际,王鹏,等.不同程度慢性阻塞性肺疾病患者的红细胞分布宽度[J].广东医学,2015,36(5):759-760.
[10]吴峰妹,黄建安.AECOPD患者血清PCT、CRP变化及临床意义[J].国际呼吸杂志,2014,34(8):581-584.
[11]Bircan A,Gokirmak M,Kilic O,et al.C-reactive protein levels inpatients with chronic obstructive pulmonary disease:Role of infection[J].Med Princ Pract,2008,17(3):202-208.
[12]Uysal OK,Duran M,Ozkan B,et al.Red cell disyribution width is associated with acute myocardial infarction in young patients[J].Cardiol J,2012,19(6):597-602.
[13]Jo YH,Kim K,Lee JH,et al.Red cell distribution width is a prognostic factor in severe sepsis and septic shock[J].Am J Emerg Med,2013,31(3):545-548.
[14]王飞,丁勇,姜婷婷,等.红细胞分布宽度对危重患者预后的评估价值[J].中华急诊医学杂志,2014,23(8):894-897.
[15]Zorlu A,Bektasoglu G,Guven FM,et al.Usefulness of admissionred cell distribution width as a predictor of early mortality in patients with acute pulmonary embolism[J].Am J Cardiol,2012,109(1):128-134.
[16]宋雨,杨媛华,王辰.红细胞分布宽度对慢性阻塞性肺疾病短期预后的预测价值[J].中国实用内科杂志,2015,35(3):239-241.
[17]陈思佳,王飞,胡善友,等.慢性阻塞性肺部疾病急性加重期患者的红细胞分布宽度与其30天预后的相关性[J].医学研究杂志,2015,44(10):80-82.
[18]李玉明,张丽霞,郭明日,等.N端脑利钠肽和红细胞分布宽度与慢性阻塞性肺疾病严重程度的相关性[J].中国慢性病预防与控制,2017,25(3):204-206.
[19]van Kimmenade RR,Mohammed AA,Uthamalingam S,et al.Red blood cell distribution width and 1-year mortality in acute heart failure[J].Eur J Heart Fail,2010,12(2):129-136.
[20]Seyhan EC,zgül MA,Tutar N,et al.Red blood cell distribution and survival in patients with chronic obstructive pulmonary disease[J].COPD,2013,10(4):416-424.
[21]Frhecz Z,Gombos T,Borgulya G,et al.Red cell distribution width in heart failure:Prediction of clinical events and relationship with markers of ineffectiveerythropoiesis,inflammation,renal function,and nutritional state[J].Am Heart J,2009,158(4):659-666.
[22]AL-Najjar Y,Goode KM,Zhang J,et al.Red cell distribution width:An inexpensive and powerful prognostic marker in heart failure[J].Eur J Heart Fail,2009,11(12):1155-1162.
[23]Allen LA,Felker GM,Mehra MR,et al.Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure[J].J Card Fail,2010,16(3):230-238.
[24]Ellis L,Hammers H,Pili R.Targeting tumor angiogenesis with histone deacetylase inhibitors[J].Cancer Lett,2009,280(2):145-153.
[25]王金艳,洪波,孙珍贵,等.红细胞分布宽度与慢性阻塞性肺部疾病继发肺动脉高压的相关性研究[J].国际呼吸杂志,2014,34(17):1301-1303.
[26]Rhodes CJ,Wharton J,Howard LS,et al.Red cell distribution width outperforms other potential circulating biomarkers in predicting survival in idiopathic pulmonary arterial hypertension[J].Heart,2011,97(13):1054-1060.