红细胞分布宽度与急性ST段抬高型心肌梗死长期预后相关性研究  

Correlation between red blood cell distribution width and long-term outcomes after acute ST-segment elevation myocardial infarction

作　　者：逯春鹏 满秀荣 穆纳新[2] 刘昶[3] 周杰 崔遥盼 王海连[2] 王丽[3] LU Chunpeng;MAN Xiurong;MU Naxin;LIU Chang;ZHOU Jie;CUI Yaopan;WANG Hailian;WANG Li(Department of Cardiology,the First Hospital of Tsinghua University,Beijing 100016,China;Department of Cardiology,Tsinghua University Yuquan Hospital,Beijing 100040,China;Department of Emergency,Beijing Friendship Hospital of Capital Medical University,Beijing 100050,China)

机构地区：[1]清华大学第一附属医院心内科,北京100016 [2]清华大学玉泉医院心内科,北京100040 [3]首都医科大学附属北京友谊医院急诊医学科,北京100050

出　　处：《中华实用诊断与治疗杂志》2019年第6期550-553,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金(81470491)

摘　　要：目的探讨红细胞分布宽度(red blood cell distribution width, RDW)对急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction, STEMI)患者临床长期预后的影响。方法 STEMI患者315例,均测定RDW,并根据RDW中位数水平分为高RDW组(RDW≥13.51%)151例和低RDW组(RDW<13.51%)164例,比较2组住院期间和随访3 a时主要不良心血管事件(major adverse cardiovascular event, MACE)发生率和病死率,采用Cox比例风险回归模型分析STEMI患者随访3 a时MACE发生的影响因素。结果高RDW组住院期间和随访3 a时MACE发生率(31.79%、12.58%)和病死率(19.21%、7.28%)均高于低RDW组(18.90%、4.88%,6.71%、3.05%)(P<0.05);年龄增高(RR=1.046,95%CI:1.004~1.092,P=0.032)、左室射血分数降低(RR=0.961,95%CI:0.928~0.996,P=0.027)、RDW增高(RR=1.456,95%CI:1.154~1.838,P=0.002)是STEMI患者随访3 a时MACE发生的影响因素。结论 RDW对STEMI的长期预后具有预测价值。Objective To study the influence of red blood cell distribution width(RDW) on the prediction of the long-term prognosis of the patients with acute ST-segment elevation myocardial infarction(STEMI). Methods Totally 315 patients with STEMI were measured RDW, and were divided into 151 patients with RDW≥13.51%(high-RDW group) and 151 patients with RDW 13.51%(low-RDW group) according to the median of RDW. The incidence of major adverse cardiovascular event(MACE) and mortality were compared during hospital stay and after 3-year follow-up. Cox proportional hazards model was used to analyze the influencing factors for MACE after 3-year follow-up. Results The incidences of MACE(31.79%, 12.58%) and mortalities(19.21%, 7.28%) were significantly higher during hospital stay and after 3-year follow-up in high-RDW group than those in low-RDW group(18.90%, 4.88%;6.71%, 3.05%)(P<0.05). The old age of patients(RR=1.046, 95%CI:1.004-1.092, P=0.032), decreased left ventricular ejection fraction(RR=0.961, 95%CI:0.928-0.996, P=0.027) and elevated RDW(RR=1.456, 95%CI:1.154-1.838, P=0.002) were the influencing factors for MACE 3 years later. Conclusion RDW can predict the long-term outcome of STEMI.

关 键 词：急性心肌梗死 红细胞分布宽度 危险因素 预后 

分 类 号：R542.22[医药卫生—心血管疾病]