平均血小板体积、红细胞分布宽度与冠心病的相关性

Correlation between mean platelet volume, red blood cell distribution width and coronary heart disease

目的：探讨平均血小板体积（MPV）、红细胞分布宽度（RDW）与冠心病的关系,并探讨MPV及RDW作为预测冠心病的界定指标.方法：回顾性收集因胸痛或胸闷等疑诊为冠心病的患者352例,根据冠状动脉造影（CAG）结果分为冠心病组225例,非冠心病组即对照组127例.比较两组的临床资料、MPV及RDW水平,分析MPV和RDW与冠心病的相关性,并观察其与冠状动脉病变支数及Gensini积分的关系,绘制MPV及RDW预测冠心病的ROC曲线,确定最佳界点（cut-off）值.结果：（1）冠心病组MPV、RDM水平均高于对照组（P＜0.05）,且随着冠脉病变支数的增加其值增加（P＜0.05）.（2）多因素Logistic回归分析显示,MPV和RDW为冠心病发生的独立危险因素（OR =2.228,95％CI：1.556～3.191,P=0.000;OR=1.269,95％ Ch 0.864～1.864,P=0.036）.（3）相关性分析显示,冠心病组MPV、RDW水平与Gensini积分呈正相关趋势（r=0.496,P＜0.05;r=0.163,P＜0.05）.（4）根据ROC曲线,MPV预测冠心病界点值为9.15fL（特异性为69.3％,敏感度为51.6％）,RDW预测冠心病界点值为12.25％（特异性为60.6％,敏感度为56％）.结论：MPV及RDW为冠心病发生的独立危险因素,且均与冠状动脉病变程度呈正相关趋势,MPV及RDW界点值有可能成为预测冠心病的指标之一.

Objective： To investigate the correlations between the levels of mean platelet volume （MPV）, red blood cell distribution width （RDW） and coronary heart disease （CHD） and to determine whether the joint detection of MPV and RDW can be an effective indicator for predicting coronary heart disease. Methods： A total of 352 consecutive patients with suspected CHD were retrospectively analyzed. All patients received coronary angiography （CAG）, and were divided into CHD group （n=225） and control group（n=127）. Their clinical data were recorded to study the correlation between MPV, RDW and CHD. The correlation between the level of MPV, RDW and the coronary lesions count, Gensini score were then assessed. ROC analyses were performed to evaluate the predictive performances of MPV and RDW for CHD and to identify the optimal cut-off point for predicting CHD. Results： （1）The levels of MPV and RDW of CHD group were significantly higher than that of the control group（P〈0.05）, and increased with coronary lesions count （P〈0.05）. （2）Multivariate logistic regression analysis showed that the levels of MPV and RDW were independent risk factors of CHD（ OR=2.228, 95%CI： 1.556-3.191 ,P=0.000; OR=1.269, 95% CI：0.864-1.864,P=0.036）. （3）Bivariate correlation analysis presented that in CHD group, the Gensini score was positively correlated to the levels of MPV and RDW （r=0.496, P〈0.05 ; r=0.163, P〈0.05）. （4）ROC analysis indicated that the optimal MPV cut-off point for predicting CHD was 9.15fL with a specificity of 69.3% and a sensitivity of 51.6%; the optimal RDW cut-off point for predicting CHD was 12.25% with a specificity of 60.6% and a sensitivity of 56%. Conclusion： The levels of MPV and RDW are independent risk factors of CHD; the levels of MPV and RDW are positively correlated with the severity of coronary lesion; the cut-off points of MPV and RDW may be effective indicators for predicting coronary heart disease.