原发性高血压患者红细胞分布宽度与Framingham心血管病风险等级的关系  

Relationship between red blood cell distribution width and the risk levels of Framingham cardiovascular score in patients with essential hypertension

作　　者：郑红梅[1] 张强[1] 杨丽红[2] 杨蕊珂[2] 王淑辉[2] 孙彩红[1] 周雨菡 

机构地区：[1]郑州大学第二附属医院心内科,河南郑州450014 [2]河南省人民医院心功能科

出　　处：《中华高血压杂志》2017年第1期38-42,共5页Chinese Journal of Hypertension

摘　　要：目的探讨原发性高血压患者红细胞分布宽度(RDW)与Framingham心血管病风险等级的关系。方法入选2014年9月至2016年8月在郑州大学第二附属医院心内科门诊及住院收治的原发性高血压患者383例,按Framingham心血管病风险等级将其分为低危组(n=176)、中危组(n=121)和高危组(n=86),另设正常血压对照组80例,检测所有患者血脂、肝肾功能、空腹血糖、RDW、高敏C反应蛋白(hsCRP)及左心室射血分数值,测量身高、体质量、血压,并计算体质量指数(BMI)。应用有序多分类Logistic回归分析RDW与Framingham心血管病风险等级的关系,采用受试者工作特征(ROC)曲线评价RDW对心血管病高危人群的判断价值。结果 4组年龄、BMI、吸烟、糖尿病、服用他汀类药物情况、收缩压、舒张压、低密度脂蛋白胆固醇(LDL-C)、胱抑素C、RDW、hsCRP等指标比较,差异有统计学意义(均P<0.05)。4组RDW比较,高危组高于中危组[(13.42±0.92)%比(12.96±0.50)%],高危组、中危组高于低危组[(12.83±0.51)%]和对照组[(12.69±0.66)%](均P<0.05)。Pearson相关分析显示RDW与LDL-C呈负相关(r=-0.105),与年龄、胱抑素C、hsCRP、Framingham心血管病风险等级呈正相关(分别r=0.182、0.151、0.566、0.312,均P<0.05)。有序多分类Logistic回归分析结果显示,在校正了年龄、BMI、吸烟、糖尿病、服用他汀类药物情况、收缩压、舒张压、LDL-C、胱抑素C、hsCRP后,RDW仍是Framingham心血管病风险等级的独立危险因素(OR=5.601,95%CI1.557~20.146)。ROC曲线分析示RDW>12.95%是预测心血管病高危人群的最佳截断点,其灵敏度为75.6%,特异度为63.9%,ROC曲线下面积为0.735(95%CI0.676~0.793,P<0.001)。结论原发性高血压患者RDW升高,原发性高血压患者RDW可能与Framingham心血管病风险等级相关。Objective To investigate the association between red blood cell distribution width （RDW） and the risk levels of Framingham cardiovascular score in patients with essential hypertension. Methods A toal of 383 patients with essential hypertension in the Department of Cardiology of the Second Affiliated Hospital of Zhengzhou University from September 2014 to August 2016 were enrolled in the study. According to the risk levels of Framingham cardiovascular score, all patients were divided into low-risk （n = 176）, moderate risk（n = 121） and high-risk group {n=86）. Eighty normotensives were enrolled as control group. The indicators of blood lipid, hepatic and renal function, fasting blood glucose, RDW and high-sensitivity C-reactive protein （hsCRP） and left ventricular ejection fraction （LVEF） value were detected. The height, weight and blood pressure were measured and body mass index {BMI） was calculated. The relationship between RDW and the risk levels of Framingham cardiovascular score was analyzed by ordinal ploytomous Logistic regression analysis. Receiver operating characteristic （ROC） curve was applied to judge the value of RDW on cardiovascular high risk scroe. Results There were statistical differences in terms of age, BMI, smoking, diabetes, taking statins, systolic blood pressure, diastolic blood pressure, low density lipoprotein cholesterol {LDL-C）, cystatin C （Cys C）, RDW and hsCRP among four groups（all P〈0.05）. RDW of high risk group was higher than that in moderate-risk group [-（ 13.42 ± 0.92 ） % vs （ 12.96 ± 0.50 ） %], and which were higher in the high risk and moderate risk group than in low-risk group [（ 12.83±0.51）%] and control group [（12.69±0.66%] （all P〈0.05）. Pearson correlation analysis suggested that RDW was negatively correlated with LDL-C（r=-0. 105） and positively correlated with age, Cys C, hsCRP, Framingham cardiovascular risk （r= 0. 182, 0. 151, 0. 566 and 0. 312 respectively, all P〈0.05）. Ordinal ploytomous Logistic

关 键 词：原发性高血压 红细胞分布宽度 Framingham风险评分 心血管病风险等级 

分 类 号：R544.11[医药卫生—心血管疾病]