红细胞分布宽度与修正休克指数对非ST段抬高型心肌梗死预后的关系研究

Predictive value of red blood cell distribution width and modified shock index in non-ST-segment elevation myocardial infarction

目的研究红细胞分布宽度(RDW)与修正休克指数(MSI)对急性非ST段抬高型心肌梗死(NSTEMI)患者短期预后的判断价值。方法选择2016年12月至2017年12月首诊的NSTEMI患者612例。依据患者血常规及MSI计算结果,分为RDW≥13.25%与RDW﹤13.25%组、MSI≥1.2与MSI﹤1.2组,记录一般资料,计算7d内全因病死率与MACE的发生率,分析RDW和MSI对NSTEMI患者短期预后的影响,采用受试工作特征(ROC)曲线下面积(AUC),评价二者对NSTEMI患者的短期预测价值。结果高RDW组与低RDW组的收缩压、舒张压、心率及Killip分级Ⅲ及Ⅳ级的差异比较均有统计学意义(P<0.05),高MSI组与低MSI组的收缩压、舒张压、心率及Killip分级Ⅲ及Ⅳ级的差异比较均有统计学意义(P<0.05)。高RDW组的MACE的发生率与全因病死率显著高于低RDW组,高MSI组的MACE的发生率与全因病死率显著高于低MSI组,差异均有统计学意义(P<0.05)。患者7d内的病死率为4.08%,RDW和MSI的ROC曲线下面积分别为0.696和0.686,对评估NSTEMI患者短期预后有统计学意义(P<0.001)。结论RDW和MSI有可能是评估NSTEMI患者短期预后的指标。

Objective To investigate the value of red blood cell distribution width(RDW)and modified shock index(MSI)in the short-term prognosis of patients with acute non-ST-segment elevation myocardial infarction(NSTEMI).Methods A total of 612 patients with NSTEMI who were initially diagnosed between December 2016 and December 2017 were selected.According to the patient’s blood routine and MSI calculation results,the patients were divided into RDW≥13.25%group,RDW<13.25%group,MSI≥1.2 group and MSI<1.2 group.The general data were recorded,and 7-day all-cause mortality rate and MACE incidence rate were calculated.The effect of RDW and MSI on the short-term prognosis of patients with NSTEMI was evaluated,and the area under receiver operating characteristic(ROC)curve(AUC)was used to evaluate the short-term predictive value of RDW and MSI in patients with NSTEMI.Results Systolic blood pressure,diastolic blood pressure,heart rate,and Killip gradesⅢandⅣwere significantly different between the high RDW group and the low RDW group(P<0.05).Systolic blood pressure and diastolic blood pressure,heart rate,and Killip gradesⅢandⅣin the high MSI group and the low MSI group were statistically significant(P<0.05).The incidence of MACE and all-cause mortality in the high RDW group were significantly higher than those in the low RDW group,and the above indicators in the high MSI group were significantly higher than those in the low MSI group(P<0.05).The 7-day mortality rate of patients was 4.08%,and the AUC of RDW and MSI was 0.696 and 0.686,respectively,which was statistically significant in assessing short-term prognosis in patients with NSTEMI(P<0.001).Conclusion RDW and MSI may be regarded as the indexes to evaluate the short-term prognosis in patients with NSTEMI.