急性ST段抬高型心肌梗死患者红细胞分布宽度与左心室收缩功能不全的关系  

Relation between RDW and left ventricular systolic dysfunction in patients with STEMI

作　　者：赵映璇 赵玉兰[1] 黄亚萍[1] 陈素芬 ZHAO Yingxuan;ZHAO Yulan;HUANG Yaping;CHEN Sufen(Department of Cardiology,the Second Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学第二附属医院心内科,郑州450000

出　　处：《实用医学杂志》2018年第24期4080-4083,共4页The Journal of Practical Medicine

基　　金：中国心血管疾病医疗质量改善项目(编号:2017006)

摘　　要：目的探讨急性ST段抬高型心肌梗死(STEMI)患者红细胞分布宽度(RDW)与左心室收缩功能不全(LVSD)的关系。方法选取2017年在郑州大学第二附属医院心内科住院的STEMI患者344例,根据其RDW四分位水平分为四组:Q1(RDW≤12.2%)、Q2(12.2%<RDW≤12.6%)、Q3(12.6%<RDW≤13.1%)、Q4(RDW> 13.1%),比较四组患者的临床资料及LVEF,分析STEMI患者RDW与LVSD的关系。结果 4组研究对象的临床资料比较:LVEF、高血压病、肌酐(Cr)差异有统计学意义(P <0.05);年龄、性别、糖尿病、吸烟、血红蛋白(Hb)、脂代谢指标、糖化血红蛋白(HbA1C)差异无统计学意义(P> 0.05),Q4组较其他三组患者高血压病患者更多,血清肌酐值更高,LVEF更低(P <0.05)。RDW与LVEF的Pearson线性相关性分析显示,STEMI患者RDW与LVEF呈显著负相关(r=-0.156,P <0.05),单因素Logistic回归分析显示,RDW(OR=1.701,95%CI:1.156～2.511,P <0.05)是STEMI患者LVSD的预测因子。进一步计算RDW预测STEMI患者LVSD的ROC曲线下面积是0.690(95%CI:0.631～0.749),当RDW在12.85%时,其诊断LVSD的敏感性和特异性较高。结论 STEMI患者的RDW与LVEF呈负相关,RDW对STEMI患者的LVSD有预测价值。Objective To observe the relation between red blood cell distribution width(RDW)and left ventricular systolic dysfunction(LVSD) in patients with acute ST-segment elevation myocardial infarction (STEMI).Methods A total of 344 patients with STEMI,who were admitted to the cardiovascular department of our hospital in 2017,were selected and divided into four groups based on the RDW at admission:Q1(RDW ≤12.2%),Q2(12.2% < RDW ≤ 12.6%),Q3(12.6% < RDW ≤ 13.1%),Q4(RDW > 13.1%). Relationship between RDW and LVSD in STEMI patients was analyzed by comparing the clinical data and LVEF in the four groups.Results LVEF,hypertension,and creatinine(Cr)were statistically significant among the four groups(P < 0.05);There were no significant differences among age,gender,diabetes,smoking,hemoglobin(Hb),lipid metabolism index,glycosylated hemoglobin and HbA1 C(P > 0.05). The Q4 group had more hypertensive patients,higher serum creatinine and lower LVEF than those of the other three groups(P < 0.05). Pearson linear correlation analysis between RDW and LVEF showed a significant negative correlation between RDW and LVEF in patients with STEMI(r =-0.156,P < 0.05). Logistic regression analysis showed that RDW(OR = 1.701;95%CI,1.156 ~ 2.511,P < 0.05)was a predictor for LVSD in STEMI. Further calculation showed the area under the ROC curve was 0.690(95%CI:0.631 ~ 0.749). When RDW was 12.85%,it had a higher sensitivity and specificity to predict LVSD.Conclusions RDW showed negative correlation with LVEF in STEMI and it would be a predictorfor LVSD.

关 键 词：红细胞分布宽度 急性ST段抬高型心肌梗死 左心室收缩功能不全 

分 类 号：R542.22[医药卫生—心血管疾病]