红细胞体积分布宽度与老年人急性ST段抬高型心肌梗死住院期间死亡关系的研究

The association between red blood cell volume distribution width and in-hospital mortality in elderly patients with acute ST segment elevation myocardial infarction

目的探讨红细胞体积分布宽度(RDW)与老年人急性ST段抬高型心肌梗死(STEMI)住院期间死亡的关系。方法回顾性分析429例因STEMI入北京医院的年龄≥65岁的老年患者。根据RDW的中位数13.33%将患者分为低RDW组(RDW<13.33%,213例)和高RDW组(RDW≥13.33%,216例)。比较两组患者住院期间病死率的差异,并分析RDW与老年STEMI患者住院期间病死率的关系。结果高RDW组老年STEMI患者住院期间病死率高于低RDW组,12.0%(26例)比3.3%(7例),差异有统计学意义(P<0.01)。在校正两组有差异的年龄、性别、平均红细胞体积、RDW分组、Killip分级后,高RDW组患者住院期间死亡风险为低RDW组患者的3.258倍(OR=3.258,95%CI:1.291~8.222,P<0.05),此外,增龄(OR=1.079,95%CI:1.003~1.161,P<0.05)、Killip分级≥Ⅲ级(OR=13.987,95%CI:6.136~31.879,P<0.01)亦是增加老年STEMI患者住院期间死亡风险的高危因素。结论 RDW水平与老年STEMI患者住院期间死亡有关,RDW是老年STEMI患者住院期间死亡的独立预测因子。

Objective The purpose of the study was to explore the association between red blood cell volume distribution width(RDW)and in-hospital mortality in elderly patients with acute ST segment elevation myocardial infarction(STEMI).Methods A total of 429 elderly patients aged≥65 years diagnosed with acute STEMI were recruited for this study.These patients were divided into 2 groups according to the median RDW:the low RDW group(RDW<13.33%,n=213)and the high RDW group(RDW≥13.33%,n=216).The in-hospital mortalty was compared between the groups,and the relationship between RDW and in-hospital mortality in elderly STEMI patients was analyzed.Results The in-hospital mortality of the high RDW group was significantly higher than that of the.low RDW group(12.0%or 26 cases vs.3.3%or 7 cases,P<0.01).After adjusting for differences in age,sex,mean erythrocyte volume,RDW grouping and Killip grade between the two groups,the risk of in-hospital death for patients in the high RDW group was 3.258 times that in the low RDW group(OR=3.258,95%CI:1.291-8.222,P<0.05).In addition,aging(OR=1.079,95%CI:1.003-1.161,P<0.05)and Killip grade≥Ⅲ(OR=13.987,95%CI:6.136-1.879,P<0.01)were also associated with increased risk of in-hospital death in elderly STEMI patients.Conclusions RDW is associated with in-hospital mortality in elderly STEMI patients and can predict in-hospital mortality of STMEI in elderly patients.