脑梗死患者颈动脉内膜中层厚度与红细胞分布宽度的相关性研究

Carotid intima-media thickness in patients with cerebral infarction and red blood cell distribution width correlation studies

目的通过横断面研究,探究急性脑梗死患者红细胞分布宽度(RDW)与颈动脉内膜中层厚度(Carotid intima-media thickness,IMT)、动脉粥样硬化相关危险因素之间的相关性以及RDW在动脉粥样硬化严重程度评估作用。方法选取2017年12月-2018年12月赣州市立医院神经内科收治的脑梗死患者256例为病例组,按红细胞分布宽度四分位数将患者分为4组,最低四分位数组,低四分位数组,高四分位数组,最高四分位数组。另选取同时期在本院体检健康成年人116例为对照组。收集临床一般信息资料、实验室检查、颈动脉超声等结果。进行RDW与IMT、apoA1/B、同型半胱氨酸、糖化血红蛋白等指标横断面研究。结果 (1)急性脑梗死组与对照组对比,RDW、HCY、HbA1C、IMT之间,P<0.05有统计学意义。(2)急性脑梗死各分组相关指标,TC、apoA1/B、同型半胱氨酸、糖化血红蛋白各组存在有统计学差异。(3)相关分析显示,颈动脉内膜中层厚度与年龄、红细胞分布宽度呈正相关,RDW与年龄、同型半胱氨酸、颈动脉内膜中层厚度呈正相关关系,与空腹血糖、总胆固醇、低密度脂蛋白、糖化血红蛋白呈负相关。结论本研究显示急性脑梗死患者随着RDW增加,IMT随之增厚,动脉粥样硬化严重程度越加明显。相关性分析显示RDW与动脉粥样硬化不可控因素年龄及可控因素同型半胱氨酸存在正相关性,与空腹血糖、总胆固醇、低密度脂蛋白、糖化血红蛋白呈负相关。这提示RDW与颈动脉内膜中层厚度及动脉粥样硬化的危险因素存在相关性,推测RDW增高为急性脑梗死及颈动脉内膜中层厚度增厚的独立危险因素。

Objective Through a cross-sectional study, we explored the correlation between red blood cell thickness(RDW)and Carotid intima-media thickness(IMT) as well as atherosclerotic related risk factors in patients with acute cerebral infarction and the role of RDW in assessing the severity of atherosclerosis. Methods Selection in December 2017-December 2018 ganzhou city hospital neurology treated 256 cases of patients with cerebral infarction group, according to the red blood cell distribution width quartile divided the patients into 4 groups, the lowest quartile array, lower quartile array, high quarterback array, the highest quartile array. The other selection period in our hospital check-up healthy adults 116 cases as control group. Collect clinical information, laboratory examination, such as carotid ultrasound results.RDW and IMT, apoA1/B, homocysteine, glycosylated hemoglobin,such as index cross-sectional study, research data application spss18.0 statistical analysis. Results(1) in acute cerebral infarction group compared with control group, RDW, HCY, HbA1C, between IMT, P<0.05 was statistically significant.(2) the acute cerebral infarction group related index, TC, apoA1/B, homocysteine, a1c between groups was statistically difference.(3) correlation analysis showed that the carotid intima-media thickness were positively correlated with age, red blood cell distribution width, RDW and age, homocysteine and carotid intima-media thickness were positively correlated, and fasting glucose, total cholesterol, low-density lipoprotein cholesterol(hdl-c), negatively correlated with glycosylated hemoglobin. Conclusion This research shows that patients with acute cerebral infarction with the increase of RDW, IMT thickening, atherosclerosis severity increasingly obvious. Correlation analysis showed that RDW was positively correlated with uncontrolled factors of atherosclerosis, age and controllable factors of homocysteine, and negatively correlated with fasting blood glucose, total cholesterol, low-density lipoprotein and glycosylated hemoglobin. This suggests RDW and carotid intima-media thickness and no correlation between a risk factor for atherosclerosis.Speculated that higher RDW for acute cerebral infarction and carotid intima-media thickness thickening of the independent risk factors.