红细胞分布宽度与冠心病相关性的性别差异探讨  

Gender differences in relationship between red cell distribution width and coronary artery disease

作　　者：马凤莲[1,2,3,4] 名盛 刘俊[1] 李小林[1] 郭远林[1] 朱成刚[1] 徐瑞霞[1] 刘庚[1] 董倩[1] 蒋立新[1] 刘奇志[6] 李建军[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外心血管病医院心血管疾病国家重点实验室血脂异常与心血管病诊疗中心,北京市100037 [2]内蒙古医科大学附属人民医院急诊科 [3]大连医科大学 [4]阜外医院 [5]内蒙古乌兰察布市卓资县人民医院内科,乌兰察布市012300 [6]大连医科大学附属第二医院心内科,大连市100046

出　　处：《中国分子心脏病学杂志》2013年第1期389-393,共5页Molecular Cardiology of China

基　　金：教育部博士点基金资助项目(20111106110013)

摘　　要：目的冠心病的临床特征具有明显的性别差异，既往研究证实红细胞分布宽度（RDW）与冠心病发生与发展有一定关系。本文探讨RDW与冠心病相关性的性别差异。方法连续收集因胸痛疑诊冠心病的患者674例，根据冠状动脉造影（CAG）结果分为冠心病组499例（男性352例，女性147例）与对照纰175例（男性89例，女性86例）。分析冠心病传统危险因素在不同性别的差异，探计RDW在不同性别冠心痛患者中的分布情况。结果不同性别总体的基线资料比较中，年龄、吸烟史、家族史、血红蛋白水平有性别差异（P〈0．05），男女两组的RDW无明显差异（P〉0．05）。不同性别的冠心病组与对照组相比，女性冠心病组与女性对照组相比，RDW显著升高[（12．9±0．7）％vs（126±0.6）％，P=0．001]，男性冠心病组与男性对照组相比，RDW无统计学差异[（13．0±0.8）％vs（12.8±1．0）％，P=0．144]。女性冠心病患者多因素logistic回归分析显示，年龄和RDW是女性冠心病患者的独立预测因素（OR=1．07，95％CI：1．03-1．10，P〈0．001；OR=203，95％CI：1．28-3．23，P〈0．01）。女性RDW的ROC曲线下面积（AUC）=0．63，95％CI：0．56-0．70，RDW界值为12．75％，敏感性为57．1％，特异性为66．3％。结论RDW与冠心病之相关性存在性别差异，是女性冠心病的独立预测因素之一。Objective To explore the gender differences in red cell distribution width （RDW） and CAD. Methods A total of 674 consecutively admitted patients from May 2011 to May 2012 in Fu Wai Hospital were analyzed. All patients had received coronary angiography （CAG） and then were divided into two groups based on the results of CAG： CAD group consisting of 499 patients （male=352, female-147）, and control group consisting of 175 subjects （male=89, female=86）. The clinical characteristics including traditional CAD risk factors were collected, and their gender differences and the gender differences in RDW and CAD were analysed. Results There were significant gender differences in age, smoking, family history, and hemoglobin among baseline characteristics （P 〈 0.05）, However, no significant gender differences in RDW was found. Female with CAD had significantly elevated RDW levels compared with those without CAD [（12.9±0.7）% vs （12.6 ± 0.6）%, P = 0.001], however, Male with CAD had not significant statistical significance compared with those without CAD [（13.0±0.8）% vs （12.8±1.0）%, P =0.144]. In multivariate Logistic regression analysis, Age and RDW were observed to be independent predictor, for angiographic CAD in female （OR= 1.07, 95%CI： 1.03-1. 10, P 〈 0.001; OR = 2.03, 95%CI： 1.28-3.23, P 〈 0.01）. In a receiver operating characteristic （ROC） curve, an RDW value of 12.75 was identified as an effective cut-point in the segregation of the presence or absence of female CAD [area under curve （AUC） - 0.63, 95%CI： 0.56-0.70], and an RDW value of 12.75 have a sensitivity of 57.1%, a specificity of 66.3%. Conclusions There were gender differences in RDW and CAD, and RDW was one of independent predictior of female with CAD.

关 键 词：红细胞分布宽度 冠心病 性别 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]