红细胞分布宽度对急性心肌梗死患者预后评价的应用价值

Application value of red cell distribution width in prognosis evaluation of patients with acute myocardial infarction

目的:研究红细胞分布宽度(RDW)对急性心肌梗死(AMI)患者预后评价的应用价值。方法:选择我院的AMI患者300例为AMI组,同期于我院进行健康体检正常者300例为健康对照组,观察AMI组治疗前、治疗后1年及健康对照组外周血心肌肌钙蛋白(cTnI)、hsCRP、同型半胱氨酸(Hcy)、RDW水平以及AMI组治疗前后心功能指标变化。结果:治疗前,与健康对照组比较,AMI组血清cTnI[(0.24±0.03)ng/ml比(19.98±2.54)ng/ml]、hsCRP[(1.05±0.18)mg/L比(17.85±1.93)mg/L]、Hcy[(6.75±0.71)μmol/L比(29.89±3.27)μmol/L]及RDW[(10.38±1.07)%比(17.95±1.93)%]水平显著升高(P均=0.001)。治疗后1年,AMI组不良预后患者57例(19%)。治疗前及治疗后1年,与良好预后患者相比,不良预后患者cTnI、hsCRP、Hcy、RDW水平均显著升高,左室收缩末期容积指数(LVESVI)、左室舒张末期容积指数(LVEDVI)均显著增大,LVEF显著降低(P<0.05或<0.01);Pearson相关性分析显示,RDW与cTnI、hsCRP、Hcy、LVESVI、LVEDVI均呈显著正相关(r=0.420~0.498,P均=0.001),与LVEF呈显著负相关(r=-0.468,P=0.001)。结论:红细胞分布宽度与心肌损伤标志物、炎性因子及心功能具有相关性,可用于评价心肌梗死患者预后。

Objective:To study application value of red cell distribution width(RDW)in prognosis evaluation of patients with acute myocardial infarction(AMI).Methods:A total of 300 AMI patients of our hospital were selected as AMI group,another 300 subjects with normal physical examination outcome simultaneously were enrolled as healthy control group.Levels of peripheral cardiac troponin I(cTnI),hsCRP,homocysteine(Hcy)and RDW in healthy control group and AMI group before and one year after treatment,and cardiac function indexes in AMI group before and after treatment were observed.Results:Compared with healthy control group before treatment,there were significant rise in levels of serum cTnI[(0.24±0.03)ng/ml vs.(19.98±2.54)ng/ml],hsCRP[(1.05±0.18)mg/L vs.(17.85±1.93)mg/L],Hcy[(6.75±0.71)μmol/L vs.(29.89±3.27)μmol/L]and RDW[(10.38±1.07)%vs.(17.95±1.93)%]in AMI group,P=0.001 all.On one year after treatment,there were 57 patients(19%)with poor prognosis in AMI group.Compared with good prognosis patients before and one year after treatment,there were significant rise in levels of cTnI,hsCRP,Hcy,RDW,left ventricular end-systolic volume index(LVESVI)and left ventricular end-diastolic volume index(LVEDVI),and significant reduction in LVEF in poor prognosis patients,P<0.05 or<0.01;Pearson correlation analysis indicated that RDW was significant positively correlated with cTnI,hsCRP,Hcy,LVESVI and LVEDVI(r=0.420-0.498,P=0.001 all),and significant inversely correlated with LVEF(r=-0.468,P=0.001).Conclusion:RDW is correlated with myocardial injury markers,inflammatory factors and cardiac function,which contribute to evaluate the prognosis of AMI patients.