急性心肌梗死溶栓前后血浆红细胞分布宽度与溶栓再通的关系  

Relationship between the plasma red blood cell distribution width and thrombolytic recanalization before and after thrombolytic therapy in acute myocardial infarction

作　　者：冯军鹏 王有恒 陈岚 FENG Jun-peng;WANG You-heng;CHEN Lan(Cardiology Department, People's Hospital of Tongchuan, Tongchuan 727000, China)

机构地区：[1]陕西省铜川市人民医院心内科,陕西铜川727000

出　　处：《临床医学研究与实践》2019年第3期25-26,36,共3页Clinical Research and Practice

摘　　要：目的观察外周血红细胞分布宽度(RDW)水平与急性心肌梗死(AMI)静脉溶栓是否再通的关系。方法选择我院收治的78例符合溶栓条件的急性ST段抬高型心肌梗死的患者为研究对象,按AMI诊疗指南,进行规范化静脉溶栓治疗,同时给予双联抗血小板聚集、抗凝、扩张冠脉、稳定斑块、保护心脏功能、积极干预并发症等治疗。根据治疗后患者冠状动脉是否再通,将患者分为再通组(55例)和未通组(23例),比较两组血浆RDW水平及不同RDW水平患者心血管不良事件的发生情况。结果 78例患者中55例患者符合溶栓再通标准,溶栓再通率为70.1%。溶栓后1周,再通组血浆RDW水平低于溶栓前和未通组溶栓后(P<0.05)。RDW高水平组患者心血管不良事件的总发生率高于RDW低水平组(P<0.05)。结论对于AMI溶栓患者,1周后测定血浆RDW能够预测其溶栓效果,反映AMI溶栓是否再通,同时低水平血浆RDW患者发生心血管不良事件的几率更低。Objective To observe the relationship between the level of plasma red blood cell distribution width(RDW)and thrombolytic recanalization before and after thrombolytic therapy in acute myocardial infarction(AMI).Methods Seventy-eight patients with acute ST-segment elevation myocardial infarction admitted in our hospital who met the conditions of thrombolysis were selected as study objects,and standardized intravenous thrombolysis was performed according to the AMI treatment guidelines.At the same time,double anti-platelet aggregation,anticoagulant,dilated coronary artery,stabilize plaque,protect heart function and actively intervely complications were given.According to whether the coronary artery was recanalization after treatment,the patients were divided into recanalization group(55 cases)and non-recanalization group(23 cases).Plasma RDW levels in the two groups and cardiovascular adverse events in patients with different RDW levels were compared.Results Among the 78 patients,55 patients met the standard of thrombolytic recanalization,and the recanalization rate of thrombolysis was 70.1%.At one week after thrombolysis,plasma RDW level in the recanalization group was lower than that before thrombolysis and in the non-recanalization group after thrombolysis(P<0.05).The total incidence of cardiovascular adverse events in the high-level RDW group was higher than that in the low-level RDW group(P<0.05).Conclusion For patients with AMI,the measurement of plasma red blood cell distribution width after one week can predict the thrombolytic effect and reflect the recanalization.At the same time,patients with low-level RDW have lower incidence of cardiovascular adverse events.

关 键 词：急性心肌梗死 溶栓再通 红细胞分布宽度 静脉溶栓 

分 类 号：R542.22[医药卫生—心血管疾病]