| Objective:By exploring the relationship of the creatinine level,RBC volume distribution width and cardiac function among acute heart failure elderly patients with normal creatinine level,and studying its influence on prognosis.We are aiming at figuring out the possible mechanism of creatinine and RBC volume distribution width in the development of acute heart failure among elderly patients.Methods:From January 2016 to December 2018,300 patients who were diagnosed with acute heart failure and over 60 years old were selected from the Department of Cardiology,Second Hospital of Shanxi Medical University.Collecting 80 cases of elderly health examination population in the same period.The indicators during hospitalization were collected,including age,sex,height,weight,cardiac function classification,EF,left ventricular end-systolic volume,BNP,erythrocyte number,RDW,ALB,urea nitrogen,urea nitrogen.Creatinine,cholesterol,triglyceride,low density lipoprotein,high density lipoprotein,monoamine oxidase,glutathione reductase and D-dimer.While the prognostic indicator was re-hospitalization 6 months after discharge and malignant arrhythmia within6 months.Based on the ground of creatinine level,52 cases were divided into the first group(Cr<60umol/L),102 cases in the second group(60<Cr<80umol/L),81 cases in the third group(80<Cr<100umol/L)and 65 cases in the fourth group(Cr<100umol/L).According to the collected RDW values,they were divided into four quantiles: RDW 1group(<12.1%,n=77),RDW 2 group(12.1-14.8%,n=80),RDW 3 group(14.8-16.65%,n=68),RDW 4 group(>16.65%,n=75).When it comes to hospitalization or not and the occurrence of malignant arrhythmia,it was divided into event group(n=232)and nonevent group(n=68).The overall characteristics of the data were analyzed,and the differences of clinical indicators among the four groups with different creatinine levels were compared.Pearson correlation analysis and linear regression analysis were used to analyze the correlation between the indicators and creatinine,red blood cell volume distribution width.The risk factors of re-hospitalization were analyzed by logistic regression analysis.Results:1.There were significant differences in BNP,RDW,D-dimer and albumin between the blank control group and different creatinine groups(P<0.05);there were significant differences in RDW,ALB,BMI,LDL,monoamine oxidase and glutathione reductase between the different creatinine levels groups(P<0.05);the proportion of sex,smoking and drinking history,age,EF,left ventricular end systolic volume,red were significant differences among the groups(P<0.05).There was no significant difference in cell number,urea nitrogen,cholesterol,triglyceride and high density lipoprotein(P>0.05).2.The results of correlation analysis showed that there was a significant negative correlation between albumin,glutathione reductase and creatinine,erythrocyte volume distribution width(r<0,P<0.05).While there was a significant posative correlation between body mass index,low density lipoprotein,monoamine oxidase(r>0,P<0.05),BNP,D-dimer(rs > 0,P< 0.05)and creatinine,erythrocyte volume distribution width.3.Multivariate stepwise linear regression was established with creatinine and the width of red blood cell volume distribution as dependent variables and the statistical significance of correlation analysis as independent variables.The results showed that there was a significant linear correlation between glutathione reductase,albumin,body mass index,monoamine oxidase,BNP and creatinine(P<0.05);On the other hand,significant linear correlation has been showed between glutathione reductase,BNP,low density,D-dimer and red blood cell volume distribution width(P<0.05).4.The proportion of re-hospitalized patients in different creatinine level groups(?2=9.349,P<0.05)and erythrocyte volume distribution width groups(?2=14.632,P<0.05)had significant statistical significances,indicating that the proportion of rehospitalized patients increased linearly with the increase of creatinine level and erythrocyte volume distribution width.The proportion of malignant arrhythmia in different SCr level groups(?2=15.817,P<0.05)and different RDW level groups(?2=15.817,P<0.05).had significant statistical significances,indicating that the proportion of malignant arrhythmia patients increased linearly with the increase of creatinine level and erythrocyte volume distribution width.5.Age,cardiac function classification,RBC volume distribution width,creatinine,BNP,D-dimer of elderly patients with acute heart failure were significantly higher than those of non-event patients,while albumin and glutathione reductase were significantly lower than those of non-event patients(P<0.05).Multivariate analysis showed that age,red blood cell volume distribution width and creatinine were account for the independent risk factors of prognosis of elderly patients with acute heart failure(P<0.05).Conclusion:The creatinine level in elderly patients with acute heart failure is correlated with the red blood cell volume distribution width.It can be used as an indicator of cardiac function,circulatory status and inflammation level.It is also an independent risk factor for hospitalization of elderly patients with acute heart failure. |
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