原发性高血压患者左心房内径与红细胞分布宽度的关系

Relationship of left atrial diameter with the red blood cell distribution width in patients with primary hypertension

目的探讨原发性高血压患者左心房内径（1eft atrial diameter,LAD）与红细胞分布宽度（red blood cell distribution width,RDW）的关系。方法选择2014年1月至2015年1月于首都医科大学宣武医院心脏科就诊的原发性高血压患者5 108例,根据纳入与排除标准,共入选580例为研究对象。依据LAD大小分为LAD增大组（196例,LAD≥40 mm）及LAD正常组（384例,LAD〈40 mm）。应用逐步多元线性回归及逐步Logistic回归分析原发性高血压患者LAD与RDW相关性。结果 LAD增大组年龄、脉压、体质量指数、左室心肌质量指数及RDW均高于LAD正常组,而左室射血分数、心输出量低于LAD正常组,差异有统计学意义（P〈0.05）。多元线性回归分析结果显示,年龄、脉压、体质量指数、左室心肌质量指数及RDW与LAD呈线性正相关。Logistic回归分析显示,RDW是LAD增大的危险因素（OR=1.269,95%CI：1.018~1.582,P=0.034）。结论原发性高血压LAD增大的患者RDW明显升高,并与LAD呈正相关,RDW可能是原发性高血压左心房增大的危险因素。

Objective To investigate the relationship between left atrial diameter（LAD） and the red blood cell distribution width（RDW）in patients with primary hypertension.Methods Overall 580 patients with essential hypertension were enrolled into our study.All patients were divided into LAD enlarged group（LAD≥40 mm,196 cases）and non-LAD enlarged group（LAD〈40 mm,384cases）.Results The age,pulse pressure,body mass index and left ventricular mass index in LAD enlarged group were significantly higher,but the level of left ventricular ejection fraction and cardiac output were lower than those in non-LAD enlarged group.The difference was statistically significant（P〈0.05）.Multiple linear regression analysis results showed that age,pulse pressure,body mass index,left ventricular mass index and RDW had a linear positive correlation with LAD.Multivariate logistic regression analysis showed that RDW was an independent predictor for the patients primary hypertension with LAD enlargement（OR=1.269,95%CI：1.018-1.582,P=0.034）.Conclusion In primary hypertension patients,LAD is correlated with the level of RDW.RDW is an independent predictor for primary hypertension with LAD enlargement.