RDW、PDW联合QTcd在急性心肌梗死临床诊断中的应用价值分析

Application Value of RDW,PDW Combined with QTcd in the Clinical Diagnosis of Acute Myocardial Infarction

目的研究红细胞分布宽度(red blood cell distribution width,RDW)、血小板分布宽度(platelet distribution width,PDW)联合QT校正离散度(QT corrected dispersion,QTcd)在急性心肌梗死(acute myocardial infarction,AMI)临床诊断中的应用价值。方法选取2017年7月至2020年12月安徽医科大学附属阜阳医院收治的147例胸痛或胸闷患者为研究对象,均详细采集病史,查体,进行心电图检查并测量QTcd,同时检测外周血RDW和PDW。分析各指标对AMI和冠状动脉完全闭塞的诊断价值。结果AMI组RDW、PDW和QTcd高于非AMI组,且冠状动脉闭塞组RDW、PDW和QTcd均高于非闭塞组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示RDW、PDW和QTcd与AMI及冠状动脉闭塞程度均密切相关(P<0.05);RDW、PDW、QTcd及三者联合检测诊断AMI的曲线下面积(area under the curve,AUC)分别为0.817、0.775、0.861和0.938,敏感度分别为60.42%、80.21%、77.08%和87.50%,特异度分别为92.16%、66.67%、84.31%和88.24%;RDW、PDW、QTcd及三者联合检测诊断AMI患者冠状动脉闭塞的AUC分别为0.671、0.824、0.680和0.865,敏感度分别为64.86%、91.89%、51.35%和81.08%,特异度分别为69.49%、61.02%、84.75%和83.05%。结论RDW、PDW和QTcd用于AMI诊断具有良好价值,同时可为评估AMI患者冠状动脉狭窄程度提供参考信息,对临床诊断和治疗均具有重要意义。

Objective To study the application value of red blood cell distribution width(RDW)and platelet distribution width(PDW)combined with electrocardiogram in the clinical diagnosis of acute myocardial infarction(AMI).Methods A total of 147 patients with chest pain or chest distress treated in our hospital from July 2017 to December 2020 were selected as the research subjects.The medical history was collected in detail,and physical examination and electrocardiogram examination were performed and QT corrected dispersion(QTcd)was measured,and peripheral blood RDW and PDW were also detected,and the diagnostic value of various indicators on AMI and coronary total occlusion was analyzed.Results The RDW,PDW and QTcd in AMI group were higher than those in non-AMI group,and the RDW,PDW and QTcd in coronary artery occlusion group were higher than those in non-occlusion group(P<0.05).Multivariate logistics regression analysis showed that RDW,PDW and QTcd were closely related to AMI and the degree of coronary artery occlusion(P<0.05).The AUC valeus of RDW,PDW,QTcd and combined detection in the diagnosing AMI were 0.817,0.775,0.861 and 0.938,and the sensitivities were 60.42%,80.21%,77.08% and 87.50%,and the specificities were 92.16%,66.67%,84.31% and 88.24%respectively.The AUC values of RDW,PDW,QTcd and combined detection in the diagnosis of coronary artery occlusion in patients with AMI were 0.671,0.824,0.680 and 0.865 respectively,and the sensitivities were 64.86%,91.89%,51.35% and 81.08%,and the specificities were 69.49%,61.02%,84.75% and 83.05%.Conclusion RDW,PDW and QTcd have good value in the diagnosis of AMI,and can provide reference information for evaluating the coronary artery occlusion in patients with AMI,and are of great significance for clinical diagnosis and treatment.