原发性高血压患者红细胞分布宽度与左心室肥厚的相关性分析

Relationship between red cell distribution width and left ventricular hypertrophy in patients with essential hypertension

目的探讨原发性高血压患者红细胞分布宽度(RDW)与左心室肥厚(LVH)之间的关系。方法入选首都医科大学宣武医院心脏科门诊新发未经治疗的原发性高血压患者500例作为研究对象,所有患者均检测生化指标及血常规指标,行超声心动图检查并计算左室心肌质量指数(LVMI)。根据LVMI将患者分为高血压合并LVH组(n=210)和高血压无LVH组(n=290),分析RDW与高血压患者LVH的相关性。结果与高血压无LVH组比较,高血压合并LVH组的RDW水平明显升高[(13.17±0.67)%vs(12.70±0.64)%]差异有统计学意义(P<0.05)。相关性分析显示,RDW水平与LVMI呈正性相关(r=0.542,P<0.05)。Logistic回归分析显示,在校正了收缩压、空腹血糖、血尿酸及估算肾小球滤过率等因素后,RDW仍是高血压伴左心室肥厚的独立危险因素(OR=2.717,95%CI 1.949-3.787,P<0.05)。结论与无左心室肥厚的高血压患者比较,高血压伴左心室肥厚患者RDW水平明显升高;RDW升高可能是高血压患者左心室肥厚的独立危险因素。

Objective To investigate the relationship between the red cell distribution width（ RDW） and left ventricular hypertrophy in essential hypertensive patients. Methods A total of 500 patients with essential hypertension were chosen from cardiac outpatients of Xuanwu Hospital. The biochemical indexes,blood routine index and echocardiography were detected,and the left ventricular myocardial mass index（ LVMI） was calculated. All patients were divided into two groups according to the LVMI： LVH group（ n = 210） and non-LVH group（ n = 290）. The correlation between RDW and LVH of hypertension patients was analyzed. Results The level of RDW in LVH group was significantly higher than in non-LVH group[（ 13. 17 ± 0. 67） % vs（ 12. 70 ± 0. 64） %,P〈0. 05]. Pearson correlation analysis showed that RDW was positively correlated with LVMI（ r = 0. 542,P〈0. 05）. Logistic analysis showed that RDW was an important independent risk factor for LVH in essential hypertension patients after adjusted for systolic blood pressure（ SBP）,uric acid（ UA）,fasting plasma glucose（ FPG）,estimated glomerular filtration rate（ e GFR）（ OR = 2. 717,95% CI 1. 949- 3. 787,P〈0. 05）. Conclusion The level of RDW increases in hypertension patients with LVH. RDW may be an independent risk factor of hypertension combined with LVH.