红细胞分布宽度对急性心源性胸痛患者短期预后的预测价值分析

Predictive value of red blood cell distribution width for short-term prognosis in patients with acute cardiogenic chest pain

目的分析急性心源性胸痛患者红细胞分布宽度与短期预后的相关性。方法选择自2014年1月～2017年8月收治的急性心源性胸痛患者242例,根据1个月内是否发生严重心血管不良事件(MACE)将其分为两组,其中未发生不良事件者221例为对照组,发生不良事件者21例为观察组,分析急性心源性胸痛患者与红细胞分布宽度的关系。采用ROC曲线下面积(AUC)评价红细胞分布宽度对短期心血管不良事件的预测价值。结果两组患者的年龄、性别、BMI、血压等指标比较,差异无统计学意义(P> 0.05)。两组患者的GRACE、HEART评分、红细胞分布宽度比较,差异有统计学意义(P <0.05)。红细胞分布宽度与GRACE、HEART评分呈正相关。采用RDW单一预测急性胸痛短期MACE效果欠佳,而联合GRACE评分或HEART评分的方法预测效果更佳。结论 RDW与急性心源性胸痛患者30 d内预后密切相关,可以作为急性心源性胸痛患者的早期危险分层指标,准确区分高危人群并对其制定有效的治疗策略。

Objective To investigate the predictive value of red blood cell distribution width for short-term prognosis in patients with acute cardiogenic chest pain.Methods 242 patients with acute cardiogenic chest pain admitted to our hospital from January 2014 to August 2017 were randomly divided into two groups according to whether there was a serious cardiovascular adverse event within 1 month,and no adverse events occurred.For example,the control group and 21 patients with adverse events were included in the observation group to analyze the relationship between the distribution of red blood cells and the distribution of red blood cells in patients with acute cardiogenic chest pain.The area under the ROC curve was used to evaluate the predictive value of red blood cell distribution width for short-term cardiovascular adverse events.Results There were no significant differences in age,gender,BMI,and blood pressure between the two groups(P >0.05).GRACE,HEART score,and red blood cell distribution width were significantly different between the two groups(P<0.05).The width of red blood cell distribution was positively correlated with GRACE and HEART scores.The short-term MACE effect of RDW alone for predicting acute chest pain was poor,but the combination of GRACE score or HEART score were better.Conclusion RDW is closely related to the prognosis of patients with acute cardiogenic chest pain within 30 days.It can be used as an early risk stratification index for patients with acute cardiogenic chest pain,accurately distinguishing high-risk groups and developing effective treatment strategies.