目的 分析老年脑梗死患者红细胞分布宽度(RDW)水平与急性左心衰竭发生的相关性.方法 选择2014年6月—2016年12月解放军第252医院神经内科治疗老年脑梗死患者300例作为研究对象,根据其是否发生急性左心衰(ALHF)分成2组,即ALHF组48例和非ALHF组252例,对其常见生化指标、心力衰竭指标及RDW水平进行检测;另外根据RDW水平的不同又分成2组,即低RDW组156例和高RDW组144例,对其急性左心衰竭发生率进行比较,并分析RDW水平同相关指标的相关性.结果 ALHF组患者RDW、WBC、Hb、BUN、SCr、BNP、NT-proBNP明显高于非ALHF组,组间比较差异具有统计学意义(t=8.385、5.871、2.478、4.688、2.792、11.433、6.143,P<0.01);高RDW组患者的急性左心衰发生率显著高于低RDW组(23.7% vs.7.1%,χ2=19.365,P=0.000);Pearson相关性分析显示脑梗死老年患者的RDW水平同WBC、Hb、BNP、NT-proBNP水平呈现出明显的正相关性(r=0.348、0.263、0.376、0.294,P=0.009、0.017、0.003、0.012);Logistic回归结果显示RDW、WBC、NT-proBNP均为老年脑梗死患者发生急性左心衰竭的独立危险因素(OR=1.838、1.783、0.985,P<0.05).结论 老年脑梗死患者RDW水平的高低同急性左心衰的发生密切相关,可用于其并发急性左心衰竭的预测参考,具有重要的临床指导意义.%Objective To analyze the changes of RDW in elderly patients with cerebral infarction,and to investigate its association with acute left heart failure.Methods Three hundred cases of elderly patients with cerebral infarction were se-lected,which were treated in hospital from June 2014 to December 2016,and they divided into ALHF group(48 cases)and non-ALHF group(252 cases)according to whether with acute left heart failure(ALHF),the biochemical markers,heart fail-ure indicators and red blood cell distribution width(RDW)were analyzed.In addition,300 cases of elderly patients with cer-ebral infarction were divided into low RDW group(156 cases)and high RDW group(144 cases)according to the difference of RDW level,the incidence of acute left heart failure were compared,and correlation between RDW levels and related inde-xes were analyzed.Results In the terms of serum RDW,the patients of ALHF group were significantly higher than those of non-ALHF group(t=8.385,P=0.000);The blood parameters(RDW, WBC, Hb), renal function index(BUN, SCr) and heart failure index(BNP,NT-proBNP)were significantly higher in ALHF group than in non-ALHF group(t=8.385, t=5.871,t=2.478,t=4.688,t=2.792,t=11.433, t=6.143; P=0.000, P=0.000, P=0.007, P=0.000, P=0.003, P=0.000,P=0.000);The incidence of acute left heart failure in high RDW group was significantly higher than that in low RDW group(χ2=19.365,P=0.000);Pearson correlation analysis showed that the level of RDW in elderly patients with cerebral infarction showed a positive correlation with WBC and Hb levels(r=0.348,r=0.263,r=0.376,r=0.294;P=0.009,P=0.017,P=0.003,P=0.012);Logistic regression analysis showed that RDW and WBC were independent risk factors for acute left heart failure in elderly patients with cerebral infarction(P=0.000,P=0.012,P=0.000).Con-clusion The level of RDW in elderly patients with cerebral infarction is closely related to the occurrence of acute left heart failure.It can be used for the prediction of acute left heart failure in elderly patients with cerebral infarction,which makes it have an important clinical significance.
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