ACS患者红细胞分布宽度与GRACE评分及心功能的关联性分析

Correlation of Red Blood Cell Distribution Width with GRACE Score and Cardiac Function in Patients with Acute Coronary Syndrome

目的探讨红细胞分布宽度（RDW）与GRACE评分在急性冠脉综合征（ACS）患者中关系,进一步分析其对心功能及30d内发生主要不良心脏事件（MACE）的影响。方法 106例ACS患者,记录GRACE评分及危险分层。根据RDW水平高低分为HRDW组（〉12.7%）和LRDW组（≤12.7%）。评价RDW与GRACE评分关系,分析RDW水平与其他生化指标关系及其预后评估。结果 GRACE评分高危组（〉140分）RDW水平显著高于中危组（109~140分）和低危组（〈109分）（P〈0.05）。HRDW组GRACE评分亦高于LRDW组（P〈0.01）。ACS患者RDW水平与GRACE评分、氨基末端脑钠肽前体（NT-proBNP）水平呈正相关（r=0.365,P〈0.01;r=0.324,P〈0.05）。对于ACS患者30d内发生MACE,RDW、GRACE评分、RDW联合GRACE评分的ROC曲线下面积分别为0.619、0.818、0.916。结论 RDW与ACS病变进展密切相关,RDW联合GRACE评分能更好地反映ACS患者危险分层和心功能。

Objective To explore the relationship between red blood cell distribution width（RDW）and GRACE score in pa- tients with acute coronary syndrome（ACS） ,and further analyze the effect of RDW on cardiac function and 30-d major adverse cardiac event（MACE）. Methods A total of 106 ACS patients were subjected to risk assessment and stratification,and GRACE risk scores were recorded. According to the RDW level, patients were divided into HRDW group （〉 12.7 %）and LRDW group （≤12.7%）. The relationship between the RDW levels and the GRACE scores or other biochemical indicators was evaluated as well as the prognosis of the patients. Results The RDW levels were significantly elevated in the high GRACE score（〉140） group when compared with those in the middle （ 109 - 140, P 〈 0.05 ） and low GRACE score （ 〈 109, P 〈0.05 ） groups. The GRACE score-was significantly higher in HRDW group than in LRDW group（P〈0.01）. RDW levels were positively correlated with GRACE scores and amino terminal-pro brain natriuretic peptide（NT proBNP）（r=0. 365 ,P〈0.01 ;r= 0. 324 ,P〈0.05）. The areas under the ROC curve in terms of RDW levels,GRACE scores and RDW plus GRACE scores predicting 30-d MACE were 0. 619,0. 818 and 0. 916,respectively. Conclusion RDW levels are closely associated with the progress of ACS. RDW lev els combined with GRACE scores can better reflect the risk stratification and cardiac function of ACS patients.