红细胞形态学参数与急性心肌梗死的相关性

The application value of RBC morphological indexes in patients with acute myocardial infarction

目的探讨红细胞形态学参数与急性心肌梗死(AMI)患者的相关性,以及对短期预后的评估价值。方法选取2016年5-8月急诊胸痛中心收治的胸痛、胸闷患者103例,诊治第一时间测定患者血常规,包括红细胞平均血红蛋白浓度(MCHC)、红细胞平均血红蛋白量(MCH)、红细胞平均体积(MCV)和红细胞分布宽度(RDW),依据急诊诊断分为AMI组(n=35)和非AMI组(n=68);通过电话随访记录患者30 d内的主要不良心血管事件(MACE)。运用描述性统计学方法分别分析两组患者红细胞形态学参数水平变化及与30 d内主要不良心血管事件发生的相关性。结果 AMI组RDW水平明显高于非AMI组[(0.141±0.014)vs.(0.133±0.010)],差异有统计学意义(P<0.05);AMI组30 d内MACE发生率显著高于非AMI组(20.00%vs.4.94%),差异有统计学意义(P<0.05);AMI组30 d内发生MACE患者RDW水平显著高于同组30 d内未发生MACE患者[(0.154±0.222)vs.(0.137±0.009)],差异有统计学意义(P<0.05);其他红细胞形态学参数(MACH,MCH,MCV)在两组水平,以及预测30 d MACE发生方面差异无统计学意义(P>0.05)。结论 RDW与AMI发生显著相关,能预测患者30 d内主要不良心血管事件的风险。

Objective To study the relationship between RBC morphological indexes and acute myocardial infarction, and assess the value of short-term prognosis. Methods From May 2016 to August 2016, a total of 103 patients with the symptoms of chest tightness or chest pain were selected in the emergency chest pain center of the First Affiliated Hospital of Sun Yat-sen University, and blood routine （including MCHC, MCH, MCV and RDW） was examined. Patients were divided into AMI group （35 cases） and non-AMI group （68 cases） according to emergency diagnosis. The major adverse cardiovascular events （MACE） within 30 days were recorded by telephone follow-up. The relationship between the changes of erythrocyte morphological parameters and the incidence of major adverse cardiovascular events in 30 days was analyzed by descriptive statistical method. Results （~） The levels of RDW in AMI group was significantly higher than that of non-AMI group I （0.141_＋0.014） vs. （0.133_＋0.010） ] （P〈0.05）. （~） The incidence rate of 30 days MACE in AMI group was significantly higher than that of the non-AMI group （P〈0.05）.（~） In the AMI group, the levels of RDW of patients with 30 days MACE was significantly higher than that of the patients with no 30 days MACE [ （0.154~0.222） vs. （0.137-＋0.009） J （P〈0.05） .（~）Differenee of the levels of the morphological indexes （MACH, MCI-I, MCV）between the two group, and the value of prognosis 30 days MACE had no statistically significant （P〉0.05）.Conclusion The levels of RDW was significant correlated with AMI, and could be used for prognosis of the risk of 30 days MACE of patients.