红细胞分布宽度与急性脑梗死患者颈动脉粥样硬化斑块的关系  

The relationship between red blood cell distribution and carotid artherosclerosis plaque in patients with acute ischemic stroke

作　　者：赵岩[1] 王银玲[1] 郑军[1] 刁莹莹[1] ZHAO Yan;WANG Yinling;ZHENG Jun(Clinical Laboratory,First Affiliated Hospital of China Medical University,Shenyang 110000,China)

机构地区：[1]中国医科大学附属第一医院检验科,辽宁沈阳110001

出　　处：《中风与神经疾病杂志》2018年第10期911-915,共5页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨红细胞分布宽度(red blood cell distribution width,RDW)与急性脑梗死(acute ischemic stroke,AIS)患者颈动脉粥样硬化斑块的稳定性和狭窄程度的关系。方法收集神经内科就诊200例AIS患者和同期入院体检69例健康者的临床资料。根据颈动脉斑块稳定性和狭窄程度分组,将AIS患者分为稳定斑块组和不稳定斑块组与轻度狭窄组和中重度狭窄组,比较各组间参数差异。结果 (1)与对照组相比,病例组患者的糖尿病、高血压、冠心病、房颤和饮酒人数、舒张压、收缩压、粒淋比、甘油三酯和RDW明显增高,差异有统计学意义(P <0. 05);(2)不稳定斑块组RDW明显高于稳定斑块组(Z=1. 91,P <0. 001),轻度狭窄组RDW低于中重度狭窄组(Z=1. 47,P=0. 027),差异有统计学意义。RDW是AIS患者颈动脉不稳定斑块的一个独立危险因素(OR=2. 55,95%CI 1. 34～4. 86,P=0. 004);(3) ROC曲线分析,RDW诊断AIS患者颈动脉不稳定斑块的曲线下面积是0. 755(0. 695,0. 817),P <0. 001; RDW对颈动脉斑块的中重度狭窄的预测曲线下面积是0. 713(0. 627～0. 798),P <0. 001。结论 RDW是AIS患者颈动脉不稳定斑块的一个独立危险因素,有望作为一个评估颈动脉斑块的廉价常规指标。Objective To evaluate the relationship between red blood cell distribution width(RDW)and the stability and stricture of carotid artery plaque in acute ischemic stroke(AIS)patients.Methods Collected the clinical data of 200 patients who were first suffered from AIS in neurology and 69 healthy control groups.According to the stability and stricture of carotid plaque,AIS patients were divided into non-unstable patch groups and unstable plaque groups with mild stricture group and moderate severe stricture group,comparing the parameter differences between groups.Result(1)Compared with the control group,the number of AIS patients with diabetes,hypertension,coronary heart disease,atrial fibrillation and alcohol consumption,diastolic blood pressure,systolic blood pressure,neutrophil lymphocyte ratios,triglyceride and RDW were significantly increased,with statistically significant differences(P<0.05).(2)The RDW of the unstable plaque group was significantly higher than that of the stable plaque group(Z=1.91,P<0.001);RDW in the mild stenosis group was statistically significant lower than that in the moderate and severe stenosis group(Z=1.47,P=0.027).RDW was an independent risk factor for carotid artery instability(OR=2.55,95%CI 1.34~4.86,P=0.004).(3)the AUC of RDW diagnosis of instable carotid plaque was 0.755(0.695,0.817),P<0.001.The AUC of RDW diagnosis of moderate severe stricture carotid plaque was 0.713(0.627~0.798),P<0.001.Conclusion RDW is an independent risk factor for carotid artery instability plaques in AIS patients,and can be used as a cheap and conventional indicator for assessing carotid artery plaque.

关 键 词：红细胞分布宽度 急性脑梗死 颈动脉斑块 稳定性 狭窄程度 

分 类 号：R743.1[医药卫生—神经病学与精神病学]