红细胞分布宽度对冠脉病变患者合并阻塞性睡眠呼吸暂停低通气综合征的预测作用  

The Role of Red Cell Distribution Width in Coronary Artery Diseases Patients Complicated with Obstructive Sleep Apnea-Hypopnea Syndrome

作　　者：任涟萍[1] 陈光瑜[2] 孙晋渊[1] 孙依萍[1] 郭雪君[1] 

机构地区：[1]上海交通大学医学院附属新华医院呼吸科,上海200092 [2]上海交通大学医学院临床流行病学研究中心,上海200092

出　　处：《中国呼吸与危重监护杂志》2013年第4期375-378,共4页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的探讨红细胞分布宽度(RDW)对于有1支以上冠脉病变患者合并存在的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)严重程度的预测价值。方法回顾性分析134例经冠脉造影检查证实有1支以上冠脉病变并行整夜多导睡眠监测(PSG)的冠脉病变患者资料,根据睡眠呼吸暂停低通气指数(AHI)进行分组,比较RDW值、甘油三酯、胆固醇、高密度脂蛋白、低密度脂蛋白、血红蛋白、白细胞、红细胞压积。结果根据AHI将134例冠脉病变患者分为合并OSAHS组和无OSAHS组,合并OSAHS组的RDW值为(13.44±1.30)%,无OSAHS组的RDW值为(13.12±0.92)%,两组间的RDW值差异无统计学意义(P>0.05)。将134例冠脉病变患者重新分组,无OSAHS及轻度OSAHS组的RDW值为(13.07±0.94)%,中重度OSAHS组的RDW值为(14.02±1.41)%,两组间RDW值的差异具有统计学意义(P<0.05);两组间血红蛋白、甘油三酯、胆固醇、高密度脂蛋白、低密度脂蛋白、血小板、红细胞压积等均无显著差异(P>0.05)。绘制RDW值预测冠脉病变患者发生中重度OSAHS的受试者工作特征曲线,曲线下面积为0.748(0.523～0.972),临界值为13.95%,其灵敏度为71.43%,特异度为82.98%。结论 RDW对发现冠脉病变患者是否合并中重度OSAHS具有一定的预测价值。Objective To investigate the role of red cell distribution width （RDW） in coronary artery diseases patients complicated with obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods 134 coronary artery diseases patients who had at least one-vessel disease confirmed by coronary angiography were investigated by polysomnography for OSAHS. The patients were classified according to the apnea hypopnea index （AHI）. The level of RDW, triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, hemoglobin,white blood cells and hematocrit were measured. The receiver operating characteristic curve was drawn to predict the moderate-severe OSAHS in coronary artery diseases patients according to RDW value. Results When 134 coronary artery diseases patients were classified into a control group and an OSAHS group according to the AHI, the level of RDW in two groups was not significantly different [ （ 13.44 ± 1.30） % vs. （ 13.12 ± 0. 92 ） %, P 〉 0. 05 ]. When 134 coronary artery diseases patients were classified into a control and mild OSAHS group and a moderate-severe OSAHS group according to the AHI, the level of RDW in two groups was significantly different [ （ 13.07 ±0. 94） vs. （ 14.02 ± 1.41 ）% ,P 〈 0. 05 ]. And no difference was found in hemoglobin, triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, platelet, and hematocrit between two groups. The ROC curve analysis revealed that thearea under ROC curve was 0. 748 （0. 523-0. 972）, and the best cut-off for moderate-severe OSAHS was 13.95% with sensitivity of 71.43% and specificity of 82. 98%. Conclusion RDW may be a useful and simple tool to predict moderate-severe OSAHS in coronary artery diseases patients.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 冠状动脉病变 红细胞分布宽度 

分 类 号：R541.4[医药卫生—心血管疾病] R766[医药卫生—内科学]