观察慢性心力衰竭患者的红细胞分布宽度（RDW），探索不同临床情况下RDW的变化情况，探讨RDW值与心力衰竭预后的关系。

选择2013年1月至2018年3月于首钢水钢总医院心内科住院的病历资料完整患者330例，其中，心力衰竭患者213例（Ⅱ级100例，Ⅲ级88例，Ⅳ级25例），心功能正常者117例（正常组）。对比不同心功能状态、住院频次患者RDW、B型钠尿肽（BNP）、左心室射血分数（LVEF）水平；比较RDW正常者（174例）与RDW增高者（39例）死亡情况；分析RDW与BNP和LVEF的相关性。

心力衰竭患者RDW、BNP水平较正常组明显升高，LVEF水平明显降低，差异有统计学意义（P＜0.05），且随着心功能分级的升高，RDW、BNP水平逐渐升高，LVEF水平逐渐降低。住院次数＞2次的心力衰竭患者RDW［（47.72±4.92）%］、BNP［（4179.10±3742.16）pg/ml］水平显著高于住院次数为1~2次者［（46.23±3.92）%，（3229.69±3231.47）pg/ml］，而LVEF值［（49.40±10.85）%］显著低于住院次数为1~2次者［（53.44±11.57）%］，差异有统计学意义（P＜0.05）。在213例心力衰竭患者中，RDW增高者死亡率（12.82%）明显高于RDW正常者（2.87%），差异有统计学意义（P＜0.05）。相关性分析显示，RDW值与BNP值呈正相关关系（r=0.542，P＜0.01），RDW与LVEF值呈负相关关系（r=-0.536，P＜0.01）。

随着心功能分级的加重和住院次数的增加，RDW呈逐渐增高趋势；随着RDW值的增高，死亡率明显增加；RDW与BNP及LVEF值具有相关性。RDW值可以作为心功能严重程度及预后不良的判断指标。

To observe the distribution of red blood cell distribution width (RDW) in patients with heart failure, to explore the change of the RDW in different clinical situations, and to analyze the association between RDW and prognostic consequences in patients with heart failure.

Three hundred and thirty patients who were admitted to Department of Cardiology, Shougang Shuigang General Hospital from January 2013 to March 2018 were analyzed, including 213 with heart failure [New York Heart Association class Ⅱ/Ⅲ/Ⅳ of 100/88/25 cases] and 117 with normal heart function. The differences in RDW, brain natriuretic polypeptide (BNP), and left ventricular ejection fraction (LVEF) among patients with different heart function classifications and different times of hospitalization were analyzed. The mortality rates were compared between the patients with normal RDW (174 cases) and those with higher RDW (39 cases). The associations between BNP, LVEF, and RDW were assessed by correlation analysis.

RDW and BNP were significantly higher and LVEF was significantly lower in patients with heart failure than in those with normal heart function (P＜0.05). With the deterioration of NYHA, RDW and BNP became higher, and LVEF became lower. Compared with patients who had 1-2 times of hospitalization, patients with ＞2 times of hospitalization had significantly higher RDW [(47.72±4.92)% vs (46.23±3.92)%] and BNP [(4179.10±3742.16) pg/ml vs (3229.69±3231.47) pg/ml, P＜0.05], and lower LVEF [(49.40±10.85)% vs (53.44±11.57)%, P＜0.05]. Among the 213 patients with heart failure, the mortality rate was significantly higher in patients with higher RDW (12.82%) than in those with normal RDW (2.87%,P＜0.05). The correlation analysis showed that the RDW and BNP were positively correlated (r=0.542, P＜0.01), while the RDW and LVEF were negatively correlated (r=-0.536, P＜0.01).

With the deterioration of the heart function and more hospitalization times, RDW shows a trend of gradual increase. With the increase of RDW, the mortality rate significantly increases. RDW is correlated with BNP and LVEF values. Therefore, RDW can be may be used as an indicator to assess the severity of cardiac function and patient prognosis.