红细胞分布宽度对评价急性心肌梗死患者行经皮冠脉介入术预后的价值分析

Value analysis of red blood cell distribution width in the evaluation of the prognosis of percutaneous coronary intervention in patients with acute myocardial infarction

目的探究红细胞分布宽度(RDW)对评价急性心肌梗死患者行经皮冠脉介入术(PCI)预后的价值。方法选取2017年1月~2019年1月江西省景德镇市第一人民医院收治的100例急性心肌梗死行PCI患者作为研究对象,根据血常规RDW水平,基于受试者工作特征曲线确定最佳阈值为12.7%,以RDW值作为分组依据,将患者分为A组(58例,RDW<12.7%)和B组(42例,RDW≥12.7%)。术后随访1年,比较患者不同时间点左心室舒张末期指数(EDVI)、左心室收缩末期指数(ESVI)、室壁运动指数(WMSI)指标及不良反应发生情况。结果发病2 d内,两组患者的EDVI、ESVI、WMSI比较,差异无统计学意义(P>0.05)。术后1、6、12个月,两组患者的EDVI、ESVI、WMSI均低于发病2 d内,差异有统计学意义(P<0.05);术后1、6、12个月,A组患者的EDVI、ESVI、WMSI均低于B组,差异有统计学意义(P<0.05)。A组患者的不良反应总发生率(5.17%)低于B组(21.42%),差异有统计学意义(P<0.05)。结论RDW<12.7%的急性心肌梗死患者行PCI后,1年内心功能恢复情况优于RDW≥12.7%患者,且不良反应总发生率较低,预后相对较好,可作为临床判断急性心肌梗死患者预后的参考依据。

Objective To investigate the value of red blood cell distribution width(RDW)in evaluation of the prognosis of percutaneous coronary intervention(PCI)in patients with acute myocardial infarction.Methods A total of 100 acute myocardial infarction patients with PCI who were admitted to the First People′s Hospital of Jingdezhen City from January 2017 to January 2019 were selected as the research objects.According to the RDW level of blood routine,the optimal threshold was determined as 12.7%based on the receiver operating characteristic curve.The patients were divided into group A(58 cases,RDW<12.7%)and group B(42 cases,RDW≥12.7%)according to RDW value.They were given postoperative 1 year of follow-up.The left ventricular end-diastolic volume index(EDVI),left ventricular end-systolic volume index(ESVI),wall motion score index(WMSI)and the incidence of adverse reactions were compared at different time between the two groups.Results There were no statistically significant differences in the EDVI,ESVI and WMSI between the two groups within 2 d of onset(P>0.05).After surgery for 1,6 and 12 months,the EDVI,ESVI and WMSI in two groups were lower than those within 2 d of onset,and the differences were statistically significant(P<0.05).After surgery for 1,6 and 12 months,the EDVI,ESVI and WMSI in group A were lower than those in group B,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in group A(5.17%)was lower than that in group B(21.42%),and the difference was statistically significant(P<0.05).Conclusion Patients with acute myocardial infarction with RDW<12.7%have better cardiac function recovery within 1 year after PCI than those with RDW≥12.7%.In addition,the total incidence of adverse reactions is lower and the prognosis is better,which can be used as a reference for clinical judgment of the prognosis of patients with acute myocardial infarction.