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目的:研究急性失代偿心力衰竭(ADHF)患者红细胞分布宽度(RDW)和Ⅰ型心肾综合征(CRS)之间的关系。方法:回顾性病例-对照研究。收集因ADHF在我院心内科住院患者的病历资料。用改善全球肾脏病预后组织(KDIGO)的急性肾损伤标准评估Ⅰ型CRS并分级。结果:本研究共纳入445例患者,其中140例(31.5%)发生Ⅰ型CRS,其RDW水平显著高于无Ⅰ型CRS者[(15.9±1.4)vs.(13.2±0.8),P<0.01]。AKI亚组1~3级的RDW水平分别为(14.2±1.2)、(15.8±1.9)和(16.4±2.2),P=0.028,有递增趋势。多变量Logistic回归模型中,经年龄、糖尿病、脑钠肽和基线估算肾小球滤过率校正后,RDW每增加1单位,Ⅰ型CRS发生风险增加39.8%(OR值1.398,95%CI1.024~1.570)。结论:RDW和ADHF患者发生急性肾损伤独立相关,可能是一种新的Ⅰ型CRS标志物。
Objective: To investigate the relationship between RDW and type Ⅰ cardiorenal syndrome (CRS) in patients with acute decompensated heart failure (ADHF). Methods: A retrospective case-control study. Collect medical records of ADHF hospitalized patients in our department of cardiology. Type 1 CRS was assessed and graded using criteria for acute kidney injury that improve global kidney disease prognosis (KDIGO). Results: A total of 445 patients were enrolled in this study. Type I CRS occurred in 140 patients (31.5%), and their RDW levels were significantly higher than those without type I CRS [(15.9 ± 1.4) vs. (13.2 ± 0.8), P <0.01 ]. The level of RDW in grade 1 to 3 in AKI subgroup was (14.2 ± 1.2), (15.8 ± 1.9) and (16.4 ± 2.2), respectively, P = 0.028, with an increasing trend. In the multivariable Logistic regression model, the risk of type 1 CRS increased by 39.8% (OR 1.398, 95% CI1) for each 1-unit increase in RDW corrected for glomerular filtration rate estimated by age, diabetes, brain natriuretic peptide, and baseline. 024 ~ 1.570). Conclusion: The acute kidney injury associated with RDW and ADHF is independently related and may be a new type Ⅰ CRS marker.