The Value Of Red Cell Distribution Width In Right Heart Failure In Patient With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

ObjectiveTo investigate the relationship between RDW and right heart failure in patients with AECOPD,in order to provide a more simple and effective biomarker for AECOPD combined with right heart failure;understand the relationship between RDW and clinical parameters of AECOPD.MethodsWe selected 156 patients who were admitted to respiratory department of The Affilia-ted Hospital of Taishan Medical University for AECOPD at the time of hospitalization from January 2015 to January 2017.Detailed medical history collection and physical examination were carried on all patients,and the demographic information,LOS,the result of examination were recorded in detail.We collected the parameters of routine blood test,C-reactive protein,Fibrinogen,NT-proBNP,Arterial blood gas analysis,as well as color doppler echocardiography.Red cell distribution width was obtained in all patients before transthoracic echocardiography.According to the RDW,we categorized the 156 AECOPD patients into elevated RDW group,non-elevated RDW group;no right heart failure and right heart failure group;according to NYHA cardiac function classification,AECOPD combined with right heart failure group was divided into Cardiac function II????.Results1.In comparison patients with an elevated RDW value and with a non-elevated RDWvalue were more likely to have a higher LOS,N%,CRP,FIB,NT-proBNP,PaCO₂levels and a lower PaO₂ levels?P<0.05?.The incidence of respiratory failure and right heart failure in patients with an elevated RDW value were all increased compared with those patients with a non-elevated RDW value.2.In comparison patients with right heart failure and with no right heart failure were more likely to have a higher age,LOS,N%,CRP,RDW,NT-proBNP,PAP,The differences were statistically significant?P<0.05?.3.The higher the grade of cardiac function,the higher the RDW value was,the difference was statistically significant between the third grade group4.RDW was correlated with LOS,CRP,N%,NT-proBNP and pulmonary arterial pressure,the correlation coefficients were 0.278,0.236,0.166,0.405,0.341,negatively correlated with PaO2,r=-0.248?all P<0.05?.ConclusionRDW with NT-proBNP and pulmonary arterial pressure are positively correlated,RDW may be considered as a marker for assessing COPD with pulmonary hypertension,with NT-proBNP synergistic diagnosis of heart failure;There was a positive correlation between RDW and inflammation index?CRP,N%?in patients with AECOPD,so RDW may be used as an objective reference to reflect the level of inflammation in patients with AECOPD.