红细胞分布宽度与冠心病的相关性研究  

Correlation between red blood cell distribution width and coronary heart disease

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

机构地区：[1]中国医学科学院北京协和医学院阜外心血管病医院血脂中心,北京100037 [2]内蒙古医科大学附属人民医院 [3]大连医科大学 [4]大连医科大学附属第二医院心内科

出　　处：《中华老年心脑血管病杂志》2013年第3期258-261,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：教育部博士点基金资助项目(20111106110013)

摘　　要：目的探讨红细胞分布宽度(RDW)与冠心病的相关性。方法连续收集因胸痛疑诊冠心病或已明确冠心病为进一步介入治疗的患者677例,根据冠状动脉造影结果确诊为冠心病499例为冠心病组,除外冠心病178例为对照组。记录2组的临床资料,分析冠心病的危险因素,探讨RDW与冠心病的相关性,采用改良Gensini法评价冠状动脉病变的严重程度,并分析其与RDW的关系。结果与对照组比较,冠心病组RDW明显升高[(13.0±0.8)%vs(12.7±0.8)%,P=0.001],且RDW与冠状动脉病变严重程度呈正相关(r=0.37,P<0.01)。多因素logistic回归分析显示,RDW是冠心病和冠状动脉病变严重程度的独立预测因素(OR=1.34,95%CI:1.02～1.77,P<0.05;OR=2.23,95%CI:1.62～3.08,P<0.01)。RDW界值为12.9%,RDW的ROC曲线下面积=0.61,95%CI:0.56～0.66,诊断的敏感性为50.0%,特异性为65.2%。结论 RDW与冠心病及冠状动脉病变严重程度独立相关,是冠心病及冠状动脉病变严重程度的独立预测因素。Objective To study the correlation between red blood cell distribution width（RDW） and coronary heart disease. Methods Six hundred and seventy-seven consecutive patients with suspected or established coronary heart disease admitted to our hospital for further intervention therapy were divided into coronary heart disease group （n = 499） and control group （n = 178）. Their clinical data were recorded. The risk factors for coronary heart disease were analyzed. The correlation between RDW and coronary heart disease was assessed with the modified Gensini sco ring method. Results The RDW was significantly higher in coronary heart disease group than in control group（13.0 %±0.8 % vs 12.7%± 0.8 %, P = 0. 001） and was positively correlated with the Gensini score （r = 0.37, P=0.01）. Multivariate logistic regression analysis showed that the RDW was an independent predictor for coronary heart disease and coronary lesion （OR = 1. 34, 95 %CI： 1.02-1.77,P〈0.05;OR=2.23,95CI： 1.62-3.08,P〈0.01）. The RDW threshold value was 12.9 and the RDW area under the ROC curve was 0. 61（95% CI：0. 56-0. 66） with a sensitivity of 50.0% and a specificity of 65.2% for the diagnosis of coronary heart disease. Conclusion RDW is independently correlated with the severity of coronary heart disease and coronary lesion, and is thus an independent predictor for the severity of coronary heart disease and coronary lesion.

关 键 词：冠心病 胸痛 冠状血管造影术 危险因素 ROC曲线 红细胞分布宽度 

分 类 号：R541.4[医药卫生—心血管疾病]