2型糖尿病合并冠心病患者的红细胞分布宽度的临床价值

Clinical value of red cell distribution width in patients with type 2 diabetes mellitus and coronary heart disease

目的:研究2型糖尿病合并冠心病患者红细胞分布宽度(red cell distribution width,RDW)的临床价值。方法:选择2015年12月到2017年12月到临高县人民医院就诊的2型糖尿病患者200例,根据是否合并冠心病分为合并组126例,未合并组74例,另选同期体检健康者200名为对照组。所有受试者检测红细胞相关参数红细胞压积(hematocrit,HCT)、平均红细胞体积(mean corpuscular volume,MCV)、RDW以及三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、空腹血糖(fasting blood glucose,FBG),合并组患者检测颈总动脉的内-中膜厚度(intima-media thickness,IMT)、颈动脉斑块Crouse积分、Gensini评分。统计对照组及糖尿病组患者相关实验室参数水平,统计合并组及未合并组患者相关实验室参数水平,统计不同IMT、Crouse积分、Gensini评分合并组患者的红细胞相关参数,分析合并组的红细胞相关参数与LDL-C,FBS,IMT,Crouse积分、Gensini评分的相关性及红细胞相关参数对糖尿病合并冠心病的预测价值。结果:糖尿病组HCT,MCV,RDW,TC,TG,LDL-C,FBS水平均高于对照组,HDL-C水平低于对照组(P<0.05);合并组HCT,MCV,RDW,LDL-C,FBS水平均高于未合并组(P<0.05);Pearson相关性分析显示糖尿病合并冠心病患者HCT,MCV,RDW水平与LDL-C,FBS水平呈显著正相关关系(P<0.05);合并组IMT,Crouse积分,Gensini评分越高则HCT,MCV,RDW水平越高(P<0.05);Pearson相关性分析显示糖尿病合并冠心病患者Gensini评分,IMT,Crouse积分与MCV,RDW呈显著正相关(P<0.05);受试者工作特征(receiver operating characteristic,ROC)曲线分析显示MCV,RDW联合检测曲线下面积(area under the curve,AUC)大于各指标单独检测(P<0.05)。结论:糖尿病合并冠心病患者MCV,RDW水平显著上升,联合上述指标可进一步提高对糖尿病合并冠心病的预测价值。

Objective:To study the clinical value of red cell distribution width(RDW)in patients with type 2 diabetes mellitus(T2DM)and coronary heart disease(CHD).Methods:A total of 200 T2DM patients who were treated in the Lingao People’s Hospital during the period from December 2015 to December 2017 were enrolled.According to presence or absence of CHD,they were divided into combination group(126 cases)and non-combination group(74 cases).Another 200 healthy people who underwent physical examination in the same period were enrolled as control group.Red cell related parameters of all people were detected,including hematocrit(HCT),mean corpuscular volume(MCV),RDW,triglyceride(TG),total cholesterol(TC),highdensity lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and fasting blood glucose(FBG).Intima-media thickness(IMT)of common arteries,Crouse score and Gensini score of carotid plaques in combination group were detected.The levels of related laboratory parameters in control group and T2DM group were statistically analyzed.The levels of related laboratory parameters in combination group and noncombination group were statistically analyzed.The erythrocyte-related parameters of patients with different IMT,Crouse and Gensini scores in combination group were statistically analyzed.The correlation between erythrocyterelated parameters and LDL-C,FBS,IMT,Crouse score,Gensini score,and the predictive value of erythrocyterelated parameters for T2DM combined with CHD in combination group were analyzed.Results:The levels of HCT,MCV,RDW,TC,TG,LDL-C and FBS in T2DM group were higher than those in control group(P<0.05),while level of HDL-C was lower than that in control group(P<0.05).The levels of HCT,MCV,RDW,LDL-C and FBS in combination group were higher than those in non-combination group(P<0.05).Person correlation analysis showed that levels of HCT,MCV and RDW were significantly positively correlated with the levels of LDL-C and FBS in patients with T2DM and CHD(P<0.05).The higher the ICT,Crouse score and Gensini score,the higher the levels of HCT,MCV and RDW in combination group(P<0.05).Person correlation analysis showed that Gensini score,IMT and Crouse scores were significantly positively correlated with MCV and RDW in patients with T2DM and CHD(P<0.05).The receiver operating characteristic(ROC)curves showed that the area under the ROC curve(AUC)of MCV combined with RDW was greater than that of single index(P<0.05).Conclusion:The levels of MCV and RDW are significantly increased in patients with T2DM and CHD.The combination of the above indexes can further improve the predictive value for T2DM combined with CHD.