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目的观察扩张型心肌病(DCM)并发心力衰竭患儿红细胞分布宽度(RDW)水平的变化,并探讨其与常用心功能评价指标的相关性。方法收集武汉市妇女儿童医疗保健中心2012年1月至2014年12月收治的并发心力衰竭的DCM患儿68例,按改良Ross评分法,将其分为轻度、中度、重度心力衰竭组,选取健康体检儿童50名作为对照组,比较各组间RDW水平的差异,并将DCM患儿RDW与血浆N-端脑利钠肽前体(NT-pro BNP)、左室射血分数(LVEF)进行相关性分析。结果 DCM合并心力衰竭组RDW水平较对照组明显升高,差异有统计学意义(P<0.01)。心力衰竭轻度、中度、重度患儿间NT-pro BNP水平逐级升高,LVEF逐级下降,差异有统计学意义(P均<0.01),而心力衰竭各组间RDW水平差异无统计学意义。RDW与NT-pro BNP、LVEF均无显著相关性(r分别为0.144、-0.158,P均>0.05)。结论 RDW升高有助于小儿DCM合并心力衰竭的诊断,但其能否作为小儿心力衰竭严重程度的判断指标尚不能明确。
Objective To observe the changes of erythrocyte distribution width (RDW) in children with dilated cardiomyopathy (DCM) complicated with heart failure and to explore its correlation with common cardiac function evaluation indexes. Methods A total of 68 children with DCM complicated with heart failure admitted from January 2012 to December 2014 in Wuhan Women and Children’s Medical Center were divided into mild, moderate and severe heart failure group according to modified Ross score method . Fifty healthy children were selected as the control group. The difference of RDW between the two groups was compared. The relationship between RDW and NT-pro BNP, left ventricular ejection fraction LVEF) for correlation analysis. Results The level of RDW in DCM group was significantly higher than that in control group (P <0.01). The level of NT-pro BNP in patients with mild, moderate and severe heart failure gradually increased, LVEF decreased step by step, the difference was statistically significant (P <0.01), but there was no statistic difference between the groups Significance of learning. There was no significant correlation between RDW and NT-pro BNP and LVEF (r = 0.144, -0.158, P> 0.05). Conclusion Increased RDW is helpful to the diagnosis of DCM complicated with heart failure in children. However, whether it can be used as an indicator of the severity of heart failure in children is not yet clear.