The Relationship Between Red Cell Distribution Width And Microalbuminuria In Chronic Heart Failure Patients

Objective:This study is to analysis the relationship of the red blood cells width(RDW) and albumin urinary(MAU) of patients with chronic heart failure(CHF) in different New York Heart Association(NYHA) heart function grades, and study the mechanism and significance, so as to help the clinical research.Content; 1、Compare the RDW, urine albumin and urinary creatinine ratio(UACR) and B type natriuretic peptide(BNP), left ventricular shot ejection fraction(LVEF) in different New York Heart Association heart function grades, with the progression of CHF trend and correlation. 2, Compare the RDW, UACR and PR, angiotensin II(ANG II), tumor necrosis factor(TNF-α)、IL-6、high-sensitivity C reactive protein(hs-CRP) in different New York Heart Association heart function grades, with the progression of CHF trend and correlation. 3. Compare the changes of RDW、UACR、BNP, LVEF, ANG II in the patients with heart failure after taking ACEI/ARB drugs. Methods: 190 patients with CHF, including 95 female patients, 95 male patients. According to the cardiac function classification criteria of the American New York heart disease association, the patients were classified, and there were 63 cases of grade IV, 64 case grade III and 63 case grade II. 100 healthy persons who participated in physical examination during the same period were treated as the control group. Patients admitted to the hospital the next day morning fasting blood determination of red cell distribution width(RDW) and brain natriuretic peptide(BNP), hemoglobin(HB), serum creatinine(SCR), then take a morning urine, to detect the urine albumin. For urinary creatinine(Cr) were measured by picric acid method, calculate the amount of albumin in the urine and urine creatinine ratio(UACR). The left ventricular mass(LVM) and left ventricular mass index(LVMI) was calculated by Devereux formula. The relationship and correlation between MAU and RDW were analyzed by using statistical method. 2, From experiment 1 in mild group, moderate group and severe group in the 10 randomly selected cases, from the control group, 30 cases were randomly selected, each RDW, UACR, PR, Ang II and TNF-α, IL-6, hs-CRP numerical determination and use statistical methods to analysis of the connection between each index and the correlation. 3, The experiment 2 moderategroup and severe combined and heart failure group(n =20), taking ACEI/ARB class of drugs was measured using drugs and RDW, UACR, BNP and LVEF, PR, Ang II numerical and with the corresponding numerical control group compared.Research results:1, With the gradual increase in the NYHA functional class, RDW, UACR, SCR, BNP, LVEDd, LVM, LVMI levels have gradually increased trend; LVEF, Hb level presented gradually decreasing trend. The levels of RDW, Hb, SCr, BNP, LVEF, LVEDd, LVM and LVMI were significantly different between the control group and the non concentric functional group(P<0.01). UACR and RDW were positively correlated with BNP, LVM,LVMI, LVEDd and SCr(P<0.01), negatively correlated with Hb and LVEF(P<0.01), UACR and RDW were positively correlated(P<0.01). 2, With the gradual increase of NYHA heart function classification, UACR, PR, RDW, ANG II, TNF IL-6, hs-CRP, levels have gradually increased. There were statistically significant differences between RDW, PR, UACR, ANG,, TNF, IL-6, hs-CRP and levels in the control group and the different functional groups(P<0.01). UACR and RDW were positively correlated with PR, ANG, TNF, IL,-6 and hs-CRP(P < 0.01). 3 The heart failure group with the control of the disease, UACR, BNP, RDW, PR, ANG II were significantly lower, LVEF had obviously picked up. The decrease amplitude of RDW was positively correlated with the decrease of BNP, PR and ANG, and the decrease of ANG and BNP, PR and UACR was positively correlated(P<0.05)Conclusion: The RDW and MAU level with NYHA class series increased continuously increased and with recognized to judge the BNP into positive correlation, in a negative correlation between LVEF. And the formation mechanism of heart failure related PR, Ang II and TNF-α, IL-6, hs-CRP was positively correlated, before and after the treatment of chronic heart failure, decrease in numerical and formation mechanism of PR, Ang II was positively related, so the evaluation of chronic heart failure is related to RDW and MAU, and the prognosis of chronic heart failure can be expressed by RDW and MAU.