The Study Of Red Cell Distribution Width In The Early Mortality Risk Of Pulmonary Thromboembolism

Objectives:Analyse the value of red cell distribution width in the early mortality risk of pulmonary thromboembolism and the assessment of right ventricular function.Methods:Collect 99 cases confirmed pulmonary thromboembolism from September 2011 to March 2014 in xx.The 99 cases of patients are distributed into four groups:low-risk group,intermediate-low –risk group,intermediate-high-risk group and high-risk group,analysis the difference and correlation between the four groups and red cell distribution width.Analysis the correlation between red cell distribution width and natriuretic peptide(BNP),troponin I(cTnI)and D-dimer level during the 99 cases.According to the RDW values,the 99 cases of patients are divided into RDW normal group(86 cases),increased RDW group(13 cases),analysis the difference of two groups in natriuretic peptide(BNP),troponin I(cTnI),right ventricular function.Results:(1)The four groups have no statistical difference in age,gender,hemoglobin,fibrinogen,low density lipoprotein,smoking history,tumor history,diabetes history,hypertension history,coronary heart disease(P>0.05).One-way analysis of variance:the red cell distribution width between the four groups statistically significant difference(P<0.001).From low-risk group to high-risk groups,with the rise of earlymortality risk,the average value of red cell distribution width increased,Using the spearman rank correlation to analyse the correlation between red cell distribution width and the early mortality risk,the results indicated that there were significantly positive correlation among red cell distribution width and the early mortality risk(r=0.558,P<0.001).Using the Fisher exact test to analyse RDW increased rate between the four groups(RDW > 14.6%),the difference was statistically significant(P<0.001).(2)Using the spearman rank correlation to analyse the correlation between red cell distribution width and brain natriuretic peptide,troponin I,D-dimer during the 99 cases,the results indicated that there were significantly positive correlation among red cell distribution width and brain natriuretic peptide(r=0.44,P<0.001),troponin I(r=0.275,P=0.006),there were no significantly correlation with D-dimer(r=0.002,P=0.981?0.05).(3)According to the levels of RDW,we divided all the 99 patients into two groups:RDW normal group,increased RDW group,the two groups have no statistical difference in age,gender,hemoglobin,fibrinogen,low density lipoprotein,smoking history,tumor history,diabetes history,hypertension history,coronary heart disease(P>0.05).Then,a comparison of natriuretic peptide(BNP),troponin I(cTnI),right ventricular function among the two groups is conducted through nonparametric rank and inspection,the result shows the BNP level was statistically difference between the two groups(P<0.001),right ventricular dysfunction rate was statistically difference(P =0.002),cTnI levels have no statistical significance between the two groups(P = 0.127).Conclusion:There were significantly positive correlation among red cell distribution width and the early mortality risk,increased RDW(RDW> 14.6%)has certain implications in the early mortality risk of intermediate-high-risk and high-risk patients with pulmonary thromboembolism,has certain clinical value for ruling out the low-risk and intermediate-low–risk patients,RDW can evaluate the severity of the PTE patients,thus guiding the treatment.Red blood cell distribution width and brain natriuretic peptide,troponin I(cTnI)were positively correlated,increased RDW(RDW> 14.6%)can prompt the possible of right ventricular involvement,to some extent,can be used to evaluate right ventricular function in patients with PTE.