红细胞分布宽度与冠心病病变程度及预后的相关性研究

Relationship between Red Blood Cell Distribution Width with the Degree of Coronary Heart Disease and the Prognosis

目的探讨冠心病患者红细胞分布宽度与冠状动脉病变严重程度及预后的关系。方法选择2012年5月至2013年5月辽河油田总医院心内科住院的冠心病患者162例,并进行冠状动脉造影以明确诊断。正常体检者54例作为对照。根据冠状动脉病变支数分为单支病变组(54例)、双支病变组(56例)及3支病变组(52例),分别检测各组红细胞分布宽度(RDW)并比较;按照RDW值的中位数(13.7%)将患者再分为两组:RDW<13.7%组(81例)和RDW≥13.7%组(81例),比较两组患者住院期间及出院半年内发生再次心肌梗死、顽固性心绞痛、新发心力衰竭、心源性病死等不良心血管事件的差异。结果冠心病各组RDW水平显著高于对照组,随着冠状动脉病变支数的增加,RDW水平也随之增加;除顽固性心绞痛组外,高RDW组发生主要不良心血管事件(MACE)的人数所占百分比均明显增加,差异有统计学意义(P<0.05或P<0.01);低RDW组患者在随访期内生存期明显高于高RDW组,差异有统计学意义(P<0.05)。结论 RDW与冠状动脉病变存在一定的相关性,可作为冠状动脉病变严重程度及预后评价的指标。

Objective To evaluate the relationship between red cell distribution width （ RDW） in coro-nary heart disease（CHD）with the severity and prognosis.Methods A total of 162 patients with CHD con-firmed by coronary angiography from Liaohe Oilfield General Hospital during May 2012 and May 2013 were included,and 54 healthy cases as controls.According to the coronary angiography,the patients were divided into three groups：one-（54 cases）,two-（56 cases）,three-（52 cases） vessel coronary artery disease group, RDW of different groups were detected and compared .According to the RDW median （13.7%） ,the patients were divided into two groups：RDW〈13.7% group （81 cases） and RDW≥13.7% group （81 cases）,and the incidence of myocardial infarction,refractory angina pectoris,new heart failure and cardiac death between the two groups were compared when they were hospitalized and six months after discharge .Results In CHD groups RDW levels were significantly higher than those of the control group .With the increase in the number of coronary lesions,RDW level gradually increased;except the intractable angina group,CHD patients in high RDW group had a higher incidence for MACE compared with those in low RDW group,and the difference was statistically significant （ P〈0.05 or P〈0.01 ）;the survival of th low RDW group was significantly higher than that of the high RDW group during the follow-up period,the difference was statistically significant （P〈0.05）.Conclusion RDW level has a certain relevance with CAD,and can be used as CAD severity and prognosis evaluation index.