红细胞分布宽度和白细胞水平与冠心病的关系

Relationship of red blood cell distribution width and white blood cell count with coronary heart disease

目的 观察红细胞分布宽度和白细胞水平与冠心病及冠状动脉病变的关系. 方法 选择行冠状动脉造影术患者590例,根据冠状动脉造影术结果分为冠心病组383例和对照组207例,并按冠状动脉病变支数将冠心病组分为不同的亚组,计算冠状动脉病变Gensini评分,比较各组间红细胞分布宽度和白细胞水平的差异,以及分析其与冠状动脉病变程度的相关性. 结果 冠心病组红细胞分布宽度和白细胞水平分别为（13.06±0.57）％、（6.33±1.56）×10^9/L,明显高于对照组（12.63±0.49）％、（5.86±1.29）×10^9/L（t=9.771、3.728,均P=0.000）,并随着冠状动脉病变支数的增加而升高（F=51.454、7.544,均P=0.000）,且与冠状动脉Gensini评分呈正相关（r=0.414、0.111,P=0.000、0.030）;红细胞分布宽度与白细胞水平呈正相关（r=0.108,P=0.009）.红细胞分布宽度对冠心病的预测价值进行受试者工作特征曲线（ROC）分析结果显示,红细胞分布宽度的界值为12.75％,ROC曲线下面积为0.723（95％ CI：0.680～0.765）,诊断的敏感度为67.6％,特异度为65.2％. 结论 红细胞分布宽度和白细胞水平在冠心病患者中明显升高,且与冠状动脉严重程度呈正相关,是冠心病的独立预测因子.

Objective To observe the relationship of the red blood cell distribution width and white blood cell count with coronary heart disease and coronary artery lesions.Methods Totally 590 patients undergoing coronary angiography were selected and divided into two groups based on the results of coronary angiography：coronary heart disease group （n=383） and control group （n=207）.Based on the number of coronary lesions,patients in coronary heart disease were divided into different subgroup.The Gensini scores of coronary lesions were assessed.The differences in red blood cell distribution and white blood cell count were compared among different groups,and the correlations of coronary lesions with red blood cell distribution and white blood cell count were analyzed.Results The red blood cell distribution and white blood cell count were higher in coronary heart disease group than in control group [（13.06±0.57）% vs.（12.63±0.49）%,（6.33±1.56） 109/L vs.（5.86± 1.29） 109/L,t=9.771 and 3.728,both P=0.000].The red blood cell distribution and white blood cell count were increased along with the increasing number of coronary lesions （F=51.454 and 7.544,both P=0.000）,and positively correlated with the Gensini score （r=0.414 and 0.111,P =0.000 and 0.030）.The red blood cell distribution was positively correlated with white blood cell count （r=0.108,P=0.009）.The receiver operating characteristic（ROC） curve for red blood cell distribution predicting coronary heart disease showed that the threshold value of red blood cell distribution was 12.75% and the area under the ROC curve was 0.723 （95% Cl：0.680-0.765） with a sensitivity of 67.6% and specificity of 65.2% for the diagnosis of coronary heart disease.Conclusions Red blood cell distribution and white blood cell count are significantly increased in patients with coronary heart disease and are independently correlated with the severity of coronary lesions.Red blood cell distribution and white blood cell count are independent predictiors for coronary artery disease.