中国中西医结合杂志2025，Vol.45Issue(7)：793-798,6.DOI:10.7661/j.cjim.20250602.046
红细胞相关指标与慢性心力衰竭不同血瘀证患者相关性研究
Correlation Study of Red Blood Cell Related Indexes with Patients with Different Blood Stasis Syndromes in Chronic Heart Failure
摘要
Abstract
Objective To investigate the differences in erythrocyte-related indices among chronic heart failure(CHF)patients with different Chinese medicine syndromes about blood stasis,and evaluate the diagnostic efficacy of hemoglobin-to-red cell distribution width ratio(HRR)and estimated plasma volume status(ePVs)in early-stage CHF.Methods A total of 450 CHF patients admitted to the Cardiology Department and Cardiac Care Unit(CCU)of Dongzhimen Hospital,Beijing University of Chinese Medicine were enrolled,including 285 cases of qi deficiency and blood stasis syndrome(QBS),78 cases of yang qi depletion and blood stasis syndrome(YBS),and 87 cases of qi and,yin deficiency and blood stasis syndrome(QYBS).Demographic and sociological characteristics,New York Heart AssociationN(YHA)functional classification,echocardiographic parameters,and serum biomarkers were collected.HRR and ePVs were calculated,and their correlations with different syndromes,NYHA classification,and left ventricular ejection fraction(LVEF)subtypes were analyzed.Diagnostic performance was assessed using receiver operating characteristic(ROC)curves.Results There was statistically difference in the distribution of NYHA classification among different CM syndrome types,among which patients with QBS predominantly presented with NYHA class Ⅲ,while those with YBS were mainly classified as NYHA class Ⅳ(x2=112.212,P＜0.001).As the syndrome evolved from QBS to QYBS and YBS,HRR and LVEF levels progressively decreased(P＜0.01),whereas ePVs and N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels increased significantly.As the NYHA classification gradually worsens,the levels of HRR and LVEF gradually decrease,while the levels of ePVs and NT-proBNP gradually increase(P＜0.01).Chinese medicine syndrome types showed moderate positive correlation with ePVs(r=0.460,P＜0.001)and weak negative correlation with LVEF(r=-0.390,P＜0.001).ROC analysis demonstrated that ePVs achieved an area under the curve(AUC)of 0.763(P＜0.001)for CHF diagnosis,with 91.5％sensitivity,50.9％specificity,and Youden index of 0.406.Conclusions YBS characterized by elevated ePVs and reduced HRR,may represent a severe CHF syndrome.ePVs exhibits significant correlation with CHF diagnosis and NYHA classification,suggesting its potential as an auxiliary biomarker for early clinical detection of CHF.关键词
慢性心力衰竭/血红蛋白/红细胞分布宽度/估计血浆容量/中医证型/相关性研究Key words
chronic heart failure/hemoglobin/red cell distribution width/estimated plasma volume/Chinese medicine syndrome types/correlation study引用本文复制引用
魏兰,牛超峰,吴卓然,王策,李蒙,张立晶..红细胞相关指标与慢性心力衰竭不同血瘀证患者相关性研究[J].中国中西医结合杂志,2025,45(7):793-798,6.基金项目
国家重点研发计划(No.2022YFC3500101) （No.2022YFC3500101）
北京中医药大学东直门医院临床研究和成果转化能力提升试点项目(No.DZMG-MSZX-24006) （No.DZMG-MSZX-24006）
