CAJ | 학술논문

目的：探讨红细胞分布宽度（RDW）、胱氨酸蛋白酶抑制剂C（CysC）、尿酸（UA）、N末端B型尿利钠肽原（NT-proBNP）与慢性心衰（ CHF）患者心功能分级及其病情预后的关系。方法回顾性分析2010年～2012年我院的慢性心衰住院患者385例，观察其RDW，CysC，UA，NT-proBNP值，并与同期138例健康对照者比较；根据不同的NYHA心功能分级分成3组，观察并比较每组的RDW，CysC，UA，NT-proBNP值；按RDW＜14．4％（289人）、RDW≥14．4％（96人）分成两组，观察患者的CysC，UA，NT-proBNP及死亡率；并对RDW，CysC，UA，NT-proBNP等因素做回归分析。结果 CHF患者的RDW，CysC，UA，NT-proBNP较健康对照组明显增高，且随着NYHA心功能级别的增高而增加；高RDW组CHF患者的CysC，UA，NT-proBNP明显高于低RDW组，且死亡率（预后）也明显升高；RDW，UA，CysC与NT-proBNP呈正相关；CysC，UA与RDW呈正相关，且CysC与UA也呈正相关。结论RDW，CysC，UA和NT-proBNP可作为心衰预后的预测因子，与CHF患者的NYHA心功能分级有关。
목적：탐토홍세포분포관도（RDW）、광안산단백매억제제C（CysC）、뇨산（UA）、N말단B형뇨리납태원（NT-proBNP）여만성심쇠（ CHF）환자심공능분급급기병정예후적관계。방법회고성분석2010년～2012년아원적만성심쇠주원환자385례，관찰기RDW，CysC，UA，NT-proBNP치，병여동기138례건강대조자비교；근거불동적NYHA심공능분급분성3조，관찰병비교매조적RDW，CysC，UA，NT-proBNP치；안RDW＜14．4％（289인）、RDW≥14．4％（96인）분성량조，관찰환자적CysC，UA，NT-proBNP급사망솔；병대RDW，CysC，UA，NT-proBNP등인소주회귀분석。결과 CHF환자적RDW，CysC，UA，NT-proBNP교건강대조조명현증고，차수착NYHA심공능급별적증고이증가；고RDW조CHF환자적CysC，UA，NT-proBNP명현고우저RDW조，차사망솔（예후）야명현승고；RDW，UA，CysC여NT-proBNP정정상관；CysC，UA여RDW정정상관，차CysC여UA야정정상관。결론RDW，CysC，UA화NT-proBNP가작위심쇠예후적예측인자，여CHF환자적NYHA심공능분급유관。
Objective To explore the relationship between red cell distribution width(RDW),Cystatin C(CysC),Uric acid ( UA) ,NT-proBNP and heart function classification and prognosis of the patients with chronic heart failure( CHF) .Methods Three hundred and eighty-five medical records from our hospital patients with CHF from 2010 to 2012 were investigated with a retrospective analysis,the RDW,CysC,UA and NT-proBNP were observed and compared with 138 healthy controls.The patients were divided into three groups accord-ing to the different NYHA classification,and the RDW,CysC,UA and NT-proBNP of each group were observed and compared.The patients were divided into two groups according to RDW<14.4%(289 cases) and RDW≥14.4%(96 cases),and the relationships among CysC, UA,NT-proBNP and the mortality were obtained.Besides,a regression analysis among RDW,CysC,UA,NT-proBNP and other factors were carried out.Results The RDW,CysC,UA,NT-proBNP of the CHF patients were significantly higher than those of healthy control groups,and the values increased with the enhancement of NYHA classification grade.The CysC,UA,NT-proBNP of CHF patients with high RDW were obviously higher than those of CHF patients with low RDW,and the mortality of the patients increased significantly.RDW,UA,CysC and NT-proBNP,CysC,UA and RDW,CysC and UA were all positively correlated.Conclusion RDW,Cys C,UA and NT-proBNP can be used as predictive factors of CHF prognosis,and were associated with NYHA heart function classification for CHF patients.