摘要
目的动态观察急性心肌梗死患者发病后第1～9天红细胞体积分布宽度(RDW)及其他红细胞参数的变化规律,以及RDW与入院后主要心血管事件(MACE)的关系。方法收集该院急性心肌梗死患者100例,于心肌梗死后1～3 d、4～6 d、7～9 d检测血常规;收集正常对照63例,比较两组患者RDW及其他红细胞参数的差异及变化规律;心肌梗死患者以MACE分为阴性组和阳性组,比较RDW的差异。结果①心肌梗死后1～9 d RDW均高于正常对照组(P<0.05),第4～6天达峰值。②急性心肌梗死后第4～6天红细胞(RBC)、血红蛋白(HB)、红细胞比容(HCT)开始下降,且逐渐降低(P<0.05)。③急性心肌梗死后第1～3天平均红细胞容积(MCV)即有增大(P<0.05),此后直至第9天有逐渐增大的趋势;平均红细胞血红蛋白含量(MCH)逐渐增大,第7～9天显著高于正常对照组(P<0.05);而各次平均红细胞血红蛋白浓度(MCHC)均低于正常对照组(P<0.05)。④急性心肌梗死MACE阳性组于心肌梗死后1～9d RDW显著高于同时期MACE阴性组(P<0.05)。结论①急性心肌梗死后第1～9天红细胞形态变异性指标———RDW增高,与急性心肌梗死入院后心血管事件发生可能有一定关联。②急性心肌梗死后1～9 d红细胞、血红蛋白计量参数下降,其他形态学参数亦发生相应变化。
【Objective】 To observe dynamic changes in red cell distribution width（RDW） and other erythrocyte parameters in patients with acute myocardial infarction（AMI） and the relationship between RDW and major adverse cardiac event（MACE）.【Methods】 A longitudinal study of erythrocyte parameters measurements was made in 100 patients with AMI every 3 days postinfarction.63 normal subjects were also recruited as control group.Baseline RDW and variability in RDW were observed during hospitalization.RDW were compared between patients with and without MACE（including acute left heart failure,shock,arrhythmias and death） during hospitalization.【Results】 RDW increased during the first 3 days postinfarction,peaking over the next 3 days,still above normal during days 7 to 9.Compared with the first 3 days,RBC,HB,HCT decreased significantly from days 4 to 9.MCV,MCH increased during the first 9 days;MCHC decreased compared with normal subjects,but no significant changes occurred during days 1 to 9.Compared with patients without MACE,RDW was higher in patients with MACE during the first 9 days postinfarction（P 0.05）. 【Conclusions】The RDW,which has increased in the first 9 days of postinfarction,may be associated with MACE during hospitalization.Erythrocyte count may decrease during the first 1 ～9 days of postinfarction,but MCV increases compensatorily.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2013年第5期93-96,共4页
China Journal of Modern Medicine
