血清红细胞分布宽度尿酸和脑钠肽联合检测在诊断慢性心力衰竭中的临床价值
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摘要
目的:联合检测血清红细胞分布宽度(RDW)、尿酸(UA)、脑钠肽(BNP)水平,探讨其在慢性心力衰竭(CHF)诊断中的价值。方法:选取2017年11月至2018年6月于承德医学院附属医院本部心脏内科住院的CHF患者80例作为心衰组。并以同期住院的心功能正常患者75例作为对照组,收集患者外周血标本,建立基线数据库。结果:与对照组相比,心衰组血清RDW、UA、BNP水平较高,并且与心功能分级呈正相关,差异具有统计学意义。ROC曲线分析显示,血清RDW、UA、BNP的曲线下面积分别是0.744,0.761,0.984,联合检测血清RDW、UA、BNP的曲线下面积是0.985,差异具有统计学意义。结论:通过联合检测血清中RDW、UA、BNP水平可以协助临床医师更好地早期诊断心衰,综合评估患者病情严重程度。
Objective: To explore the diagnostic value of combined detection of serum erythrocyte distribution width(RDW), uric acid(UA) and brain natriuretic peptide(BNP) levels in patients with chronic heart failure(CHF).Methods: Eighty patients with CHF admitted to the Department of Cardiology, Affiliated Hospital of Chengde Medical College from August 2017 to June 2018 were selected as CHF group.Seventy-five patients with normal cardiac function were selected as control group.Peripheral blood samples were collected from patients.The baseline database was established.Results:Compared with the control group, the levels of serum RDW, UA and BNP in CHF group were higher and positively correlated with the grading of cardiac function. With the increase of the grading of cardiac function, the levels of serum RDW, UA and BNP gradually increased, with statistical significance. ROC curve analysis showed that the area under the curve of serum RDW, UA and BNP was 0.744, 0.761 and 0.984, respectively. The area under the curve of combined detection of serum RDW, UA and BNP was 0.985, with statistical significance.Conclusion: Combined detection of serum levels of RDW, UA and BNP can help clinicians better diagnose CHF in early stage, comprehensively evaluate the risk stratification of patients' condition, and provide objective and comprehensive diagnostic value.
Objective: To explore the diagnostic value of combined detection of serum erythrocyte distribution width(RDW), uric acid(UA) and brain natriuretic peptide(BNP) levels in patients with chronic heart failure(CHF).Methods: Eighty patients with CHF admitted to the Department of Cardiology, Affiliated Hospital of Chengde Medical College from August 2017 to June 2018 were selected as CHF group.Seventy-five patients with normal cardiac function were selected as control group.Peripheral blood samples were collected from patients.The baseline database was established.Results:Compared with the control group, the levels of serum RDW, UA and BNP in CHF group were higher and positively correlated with the grading of cardiac function. With the increase of the grading of cardiac function, the levels of serum RDW, UA and BNP gradually increased, with statistical significance. ROC curve analysis showed that the area under the curve of serum RDW, UA and BNP was 0.744, 0.761 and 0.984, respectively. The area under the curve of combined detection of serum RDW, UA and BNP was 0.985, with statistical significance.Conclusion: Combined detection of serum levels of RDW, UA and BNP can help clinicians better diagnose CHF in early stage, comprehensively evaluate the risk stratification of patients' condition, and provide objective and comprehensive diagnostic value.
引文
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[2] Mantovani A,Targher G,Temporelli PL,et al.Prognostic impact of elevated serum uric acid levels on long-term outcomes in patients with chronic heart failure:a post-hoc analysis of the GISSI-HF (Gruppo italiano per lo studio della sopravvivenza nella Insufficienza cardiaca-heart failure) Trial[J].Metabolism,2018,83:205～215.
[3] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):98～122.
[4] Zheng YR,Ye LF,Cen XJ,et al.Low NT-proBNP levels:An early sign for the diagnosis of ischemic heart failure[J].International Journal of Cardiology,2017,228 :666～671.
[5] van Kimmenade RR,Mohammed AA,Uthamalingam S,et al.Red blood cell distributionwidth and 1-year mortality in acute heart failure[J].Eur Heart Fail,2010,12(2):129～136.
[6] Tonelli M,Sacks F,Arnold M,et al.Relation between red blood cell distribution width andcardiovascular event rate in people with coronary disease[J].Circulation,2008,117(2):163～168.
[7] Doehner W,von Haehling S,Anker SD.Uric acid as a prognosticmarker in acute heart failure:new expectations from an oldmolecule[J].Eur Heart Fail,2007,9(5):437～439.