冠心病及冠心病并发高血压患者外周血红细胞参数变化及临床意义

Changes and clinical significance of peripheral blood red blood cell parameters in patients with CHD and CHD complicated with hypertension

目的研究外周血红细胞参数在冠心病(CHD)及CHD并发高血压(HBP)患者中的变化及临床意义。方法收集2016年1月至2017年7月在武汉大学人民医院确诊为CHD的患者200例(CHD组);CHD并发HBP患者274例(CHD并发HBP组),并按照患者血压水平将其分为HBPⅠ、Ⅱ、Ⅲ级3个亚组;以同期同科室因胸闷胸痛等症状进行冠状动脉造影技术排除CHD的患者200例为对照组。比较3组红细胞计数(RBC-C)、血红蛋白(Hb)、红细胞压积(PCV)、红细胞平均体积(MCV)、红细胞平均血红蛋白含量(MCH)、红细胞平均血红蛋白浓度(MCHC)、红细胞分布宽度标准差(RDW-SD)、红细胞分布宽度变异系数(RDW-CV)的水平差异;并探究CHD并发不同严重程度HBP患者以上指标的变化趋势。结果 CHD组和CHD并发HBP组的RBC-C、Hb、PCV、MCV、MCHC水平均低于对照组,差异有统计学意义(P<0.05);而RDW-SD、RDW-CV水平高于对照组,差异有统计学意义(P<0.05)。随着HBP严重程度的升高,RBC-C、Hb、PCV、MCV、MCH、MCHC的水平降低,呈明显下降趋势;而RDW-SD、RDW-CV的水平随之升高,呈明显的上升趋势。结论 RBC-C、Hb、PCV、MCV、MCHC、RDW-SD与CHD及CHD并发HBP的发生发展关系密切,对于诊断评估CHD患者,及CHD并发HBP有一定的价值。

Objective To investigate the changes and clinical significance of red cell index in patients with coronary heart disease （CHD） and CHD complicated with hypertension （HBP）. Methods Totally 200 CHD patients and 274 patients with CHD and HBP were collected from January 2016 to July 2017 in Renmin Hospital of Wuhan University.According to the blood pressure level,patients with CHD and HBP will be divided into HBP Ⅰ,Ⅱ,Ⅲ three sub groups.And 200 cases who did coronary artery angiography to exclude CHD because of chest pain and other symptoms as control group.The red blood cell count （RBC-C）,hemoglobin （Hb）,hematocrit （PCV）,mean corpuscular volume （MCV）,mean corpuscular hemoglobin （MCH）,mean corpuscular hemoglobin concentration （MCHC）,red blood cell distribution width of the standard deviation （RDW-SD）,red blood cell distribution width coefficient of variation （RDW-CV） among three groups were compared,and the change trend of the above indexes in CHD patients with different severity of HBP was explored. Results The levels of RBC-C,Hb,PCV,MCV,HBP and MCHC in the CHD group,CHD and HBP group were lower than those in the control group,and the difference was statistically significant （ P 〈0.05）,while the levels of RDW-SD and RDW-CV were higher than those of the control group,and the difference was statistically significant （ P 〈0.05）.With the increase of HBP level,the level of RBC-C,Hb,PCV,MCV,MCH and MCHC decreased,showing a significant downward trend,while the level of RDW-SD and RDW-CV increased,showing a marked upward trend. Conclusion RBC-C,Hb,PCV,MCV,MCHC,RDW-SD are closely related to the occurrence and development of CHD and CHD complicated with HBP.It is of certain value for the diagnosis and evaluation of CHD patients and CHD complicated with HBP.