RDW与衰弱老年急性心肌梗死病人短期预后的关系

ASSOCIATION BETWEEN RED BLOOD CELL VOLUME DISTRIBUTION WIDTH AND SHORT-TERM PROGNOSIS IN WEAK ELDERLY PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

目的探讨红细胞体积分布宽度(RDW)与衰弱老年急性心肌梗死(AMI)病人短期预后关系。方法选取2012年12月—2016年12月入住我院并且诊断为AMI的衰弱老年病人669例,根据总体RDW的四分位数分为4组,比较4组病人的住院病死率。通过ROC曲线估算RDW的诊断截点,并根据此截点将病人分为2组进行生存分析,再通过寿命表法、COX回归分析评估RDW的预后预测价值。结果随着RDW的增大,病人的住院死亡率增加,差异有统计学意义(χ~2=30.230,P<0.01)。RDW的ROC曲线下面积为0.66(95%CI=0.556～0.704,P<0.01),并由此推算出RDW的诊断截点为13.05%(灵敏度55.8%、特异度68.8%)。COX回归分析结果显示,RDW不是影响衰弱老年AMI病人住院死亡率的独立危险因素。结论 RDW并不是衰弱老年AMI病人短期预后的独立危险因素。

Objective To investigate the association between red blood cell volume distribution width(RDW)and short-term prognosis in weak elderly patients with acute myocardial infarction(AMI).Methods A total of 669 weak elderly patients who were admitted to our hospital from December 2012 to December 2016 and were diagnosed with AMI were enrolled and divided into four groups according to the quartile of RDW,and the in-hospital mortality rate was compared between the four groups.The receiver operating characteristic(ROC)curve was used to estimate the diagnostic cut-off value of RDW,and the patients were divided into two groups according to this cut-off value for survival analysis.The life-table method and Cox regression analysis were used to evaluate the value of RDW in predicting prognosis.Results The in-hospital mortality rate increased with the increase in RDW(χ^2=30.230,P<0.01).RDW had an area under the ROC curve of 0.66(95%confidence interval=0.556-0.704,P<0.01)and a diagnostic cut-off value of 13.05%,with a sensitivity of 55.8% and a specificity of 68.8%.The Cox regression analysis showed that RDW was not an independent risk factor for in-hospital mortality rate in weak elderly patients with AMI.Conclusion RDW is not an independent risk factor for the short-term prognosis of weak elderly patients with AMI.