红细胞分布宽度、血尿酸和D-二聚体及B型利钠肽在急性冠脉综合征中的水平变化及意义

Changes and significance of red blood cell distribution width,blood uric acid,D-Dimer and B-ype natriuretic peptide in acute coronary syndrome

目的研究红细胞分布宽度(RDW)、血尿酸(BUA)、D-二聚体(D-Dimer)和B型利钠肽(BNP)水平在急性冠脉综合征(ACS)中的意义。方法收集2017年1月—2019年3月因ACS在蚌埠市第三人民医院住院行冠脉造影的171例患者为试验组,取同期冠脉造影或冠脉CT无明显异常患者65例为对照组,比较2组RDW、BUA、D-二聚体和BNP。试验组采用Gensini评分分组,分析各组4项指标;按患者住院期间的心血管不良事件发生情况(MACE)分组,分析各组4项指标。采用logistic回归分析研究4项指标与ACS的关系。结果试验组RDW、BUA、D-二聚体和BNP水平均高于对照组(均P<0.01);不同Gensini评分各组RDW、D-二聚体和BNP差异均有统计学意义(均P<0.01);不同MACE组内4项指标差异有统计学意义(均P<0.01)。Logistic回归分析示4项指标均与ACS相关,灵敏度分别为0.468、0.544、0.655、0.404,特异度为0.738、0.662、0.708、0.754,AUC为0.610、0.617、0.670、0.584,4项指标组成联合因子灵敏度为0.731,特异度为0.631,AUC为0.714。结论RDW、BUA、D-二聚体和BNP与ACS患者病情相关,4项指标联合检测在ACS诊断中有临床意义。

Objective To study the significance of red blood cell distribution width(RDW),blood uric acid(BUA),D-Dimer and B-type natriuretic peptide(BNP)levels in acute coronary syndrome(ACS).Methods Total 171 patients with ACS who underwent coronary angiography in the Third People's Hospital of Bengbu City from January 2017 to March 2019 were collected as experimental group,and 65 patients with no obvious abnormalities in coronary angiography or coronary CT during the same period were selected as controls group.The RDW,BUA,D-Dimer and BNP of the two groups were compared.The experimental group was divided into groups by Gensini score,and 4 indicators of each group were analyzed.The patients were grouped according to the adverse cardiovascular events(MACE)during hospitalization,and 4 indicators in each group were analyzed.Logistic regression was used to analyze the relationship between 4 indicators and ACS.Results The levels of RDW,BUA,D-Dimer and BNP in the experimental group were higher than those in the control group(all P<0.01).Gensini scores were different in each group in RDW,D-Dimer and BNP(all P<0.01).There were differences in 4 indicators in the MACE group(all P<0.01).Logistic regression analysis showed that the 4 indicators were all related to ACS,the sensitivity were 0.468,0.544,0.655 and 0.404,the specificity were 0.738,0.662,0.708 and 0.754,and the area under the curve(AUC)were 0.610,0.617,0.670 and 0.584,respectively.The sensitivity of the combination factor composed of four indicators was 0.731,the specificity was 0.631,and the AUC was 0.714.Conclusion RDW,BUA,D-Dimer and BNP are related to the condition of ACS patients.The combined detection of 4 indicators has clinical significance in ACS.