摘要
目的 探讨红细胞分布宽度(red cell distribution width,RDW)值对非瓣膜性心房颤动(atrial fibrillation,AF)患者左心房血栓(left atrial thrombus,LAT)或左心房自发性显影(left atrial spontaneous echo contrast,LASEC)的预测价值。方法 回顾性分析2010年1月至2013年12月于广东省心血管疾病研究所住院并行经食管心脏超声心动图(transesophageal echocardiography,TEE)检查的579例非瓣膜性AF患者[男404例,女175例,年龄(53.33±12.06)岁],分析患者的临床资料、血常规、经胸心脏超声心动图(transthoracic echocardiography,TTE)及TEE检查结果。结果 TEE检查发现LAT/LASEC患者28例,LAT/LASEC患者的RDW值要显著高于无LAT/LASEC患者,差异有统计学意义(14.08%±1.27%vs.13.57%±0.18%,P=0.014)。根据RDW值绘制的LAT/LASEC的受试者工作特征曲线(receiver operator characteristic curve,ROC)分析提示,预测LAT/LASEC的最佳节点为13.4%,其曲线下面积为0.625,P=0.025。多因素Logistic回归分析提示RDW〉13.4%是LAT/LASEC的独立危险因素(OR=2.844,95%CI:1.163-6.951,P=0.022)。结论 在AF患者中,LAT/LASEC患者RDW值要显著高于无LAT/LASEC患者,且RDW值升高对LAT/LASEC有一定的预测价值,RDW〉13.4%可作为AF患者LAT/LASEC的独立危险因素。
Objectives To evaluate the predictive value of red cell distribution width (RDW) on left atrial thrombus (LAT) or left atrial spontaneous echo contrast (LASEC) in patients with non-valvular atrial fibrillation (AF). Methods The study enrolled 579 patients [404 males, 175 females, mean age of (53.33±12.06) years] who were diagnosed as non-valvular AF and underwent transesophageal echocardiography (TEE) in Guangdong Cardiovascular Institute from January 2010 to December 2013. The baseline clinical characteristics, blood routine, results of transthoracic echocardiography (TTE) and TEE were analysed. Results Twenty-eight patients were found LAT/LASEC on TEE. The mean RDW level was significantly higher in LAT/LASEC patients compared with that in non-LAT/LASEC patients (14.08%±1.27% vs. 13.57%±0.18%, P=0.014). Receiver operator characteristic curve (ROC) presented by RDW level indicated that area under the curve was 0.625 (P=0.025), and the optimal cnt-off point of RDW was 13.4%. Furthermore, multivariate Logistic regression analysis indicated that RDW level〉13.4% could be an independent risk factor for LAT/LASEC in patients with AF (OR=2.844,95% CI: 1.163-6.951 ,P=0.022). Conclusions Elevated RDW level is associated with the presence of LAT/LASEC and it has moderate predictive value for LAT/LASEC in patients with AF. RDW level〉 13.4% can be an independent risk factor for LAT/LASEC in patients with AF.
出处
《岭南心血管病杂志》
2016年第2期153-157,共5页
South China Journal of Cardiovascular Diseases
关键词
心房颤动
红细胞分布宽度
左心房血栓
左心房自发性显影
atrial fibrillation
red cell distribution width
left atrial thrombus
left atrial spontaneous echo contrast