红细胞分布宽度在冠心病风险评估和诊断中的价值

The value of red blood cell distribution width in risk assessment and diagnosis of coronary heart disease

目的分析红细胞分布宽度(RDW)在冠心病风险评估和诊断中的应用价值。方法选择2017年11月-2018年11月广东省工人医院收治的冠心病患者60例为观察组,另外同期选取健康受检者100名为对照组,测定2组白细胞计数、红细胞计数、血红蛋白、红细胞平均体积、血细胞比容、RDW、血小板计数及平均血小板体积各项指标。从性别层面分析,整理研究对象吸烟史、收缩压、胆固醇、年龄进行Framingham危险评分。将观察组患者分为单支病变亚组、双支病变亚组、三支病变亚组,比较3亚组平均红细胞体积、RDW及白细胞计数水平。结果观察组白细胞计数及RDW均高于对照组,差异均有统计学意义(P<0.05),2组红细胞计数、血红蛋白、红细胞平均体积、血细胞比容、血小板计数及平均血小板体积比较差异无统计学意义(P>0.05)。从性别层面分析,整理研究对象吸烟史、收缩压、胆固醇、年龄进行Framingham危险评分,显示观察组评分结果为(9.82±4.16)分高于对照组的(6.52±2.16)分,差异有统计学意义(P<0.05)。观察组冠心病患者60例中单支病变亚组26例,双支病变亚组19例,三支病变亚组15例,不同病变支数红细胞体积、白细胞计数水平比较差异无统计学意义(P>0.05),三支病变亚组RDW高于其他2亚组,差异有统计学意义(P<0.05)。红细胞计数、血红蛋白、红细胞平均体积、血细胞比容、血小板计数、平均血小板体积和RDW不存在相关性,但RDW与白细胞计数和Framingham危险评分呈正相关(r=0.129、0.216,P<0.05)。实施Logistic多元回归分析,RDW是冠心病的独立危险因素。结论 RDW用于冠心病的风险评估和诊断中有重要参考价值,值得推广。

Objective To study the application value of red blood cell distribution width(RDW) in the risk assessment and diagnosis of coronary heart disease. Methods 60 patients with coronary heart disease admitted to Guangdong Provincial Workers Hospital from November 2017 to November 2018 were selected as observation group, and 100 healthy controls were selected in the same period as control group. The white blood cell count, red blood cell count, hemoglobin, mean red blood cell volume, hematocrit, RDW, platelet count and mean platelet volume were measured of two groups. From the gender level, the subjects′ smoking history, systolic blood pressure, cholesterol, and age were graded for the Framingham risk score. Patients in observation group were divided into single-vessel subgroup, double-vessel subgroup, and three-vessel subgroup. The average red blood cell volume, RDW and white blood cell count level of three subgroups were compared. Results The white blood cell count and RDW of observation group were higher than control group, and the difference was statistically significant(P<0.05). There were no significant differences in the red blood cell count, hemoglobin, mean red blood cell volume, hematocrit, platelet count and mean platelet volume between two groups(P>0.05). From the gender level analysis, the subjects′ smoking history, systolic blood pressure, cholesterol, and age were graded for the Framingham risk score, which showed that the observation group score was(9.82±4.16) points higher than(6.52±2.16) points of control group, the difference was statistically significant(P<0.05). Among the 60 patients with coronary heart disease, the single-vessel disease subgroup had 26 patients, double-vessel disease subgroup had 26 patients, and three-vessel disease subgroup had 15 patients. The RDW of the three-vessel subgroup was higher than the other two subgroups, and the difference was statistically significant(P<0.05). There was no correlation between red blood cell count, hemoglobin, mean red blood cell volume, hematocrit, platelet count, mean platelet volume, and RDW, but RDW was positively correlated with white blood cell count and Framingham risk score(r=0.129, 0.216, P<0.05). Logistic multiple regression analysis was performed, and RDW was an independent risk factors for coronary heart disease. Conclusion The RDW has important reference value for risk assessment and diagnosis of coronary heart disease, and it is worthy of promotion.