红细胞分布宽度与药物洗脱支架再狭窄的相关性分析

Correlation between the width of red blood cell distribution and restenosis of drug-eluting stents

目的:本研究主要探索红细胞分布宽度(red blood cell distribution width,RDW)与支架内再狭窄(in-stentrestenosis,ISR)的相关性。方法:纳入于南阳市第一人民医院,成功置入药物洗脱支架(drug-eluting stents,DES),并在术后9~12个月复查冠状动脉造影的患者,依据复查结果进一步将研究人群分为ISR组与非ISR组。本研究主要通过RDW-变异系数(RDW-CV)及RDW-标准差(RDW-SD)衡量RDW。结果:本研究共纳入研究人群203例,在术后9~12个月时,共有34例发生了DES-ISR。DES-ISR组较非DES-ISR组具有较高的RDW-CV[(13.8±0.9)%vs.(13.0±0.7)%与RDW-SD(43.2±1.9)vs.(41.7±2.5)fL]。多因素回归分析校正传统危险因素后,RDW-CV(OR=3.105,95%CI:1.892~5.094,P<0.001)与RDW-SD(OR=1.347,95%CI:1.143~1.589,P<0.001)仍是DES-ISR的危险因素。进一步通过受试者工作特征曲线分析证实RDW-CV与RDW-SD可有效预测DES-ISR的发生风险,其曲线下面积分别为0.789、0.703。结论:成功置入DES的患者,RDW(RDW-CV及RDW-SD)与中远期ISR风险相关。

Objective:In recent years,many studies have suggested that red blood cells distribution width(RDW)can not only reflect the inflammatory state in the body,but also be closely related to the poor prognosis of cardiovascular disease.This study mainly explored the relationship between RDW and in-stent restenosis(ISR).Methods:This study mainly included patients who were successfully implanted with drugeluting stents(DES)in our hospital and underwent coronary angiography at 9-12 months after operation.And the study population was further divided into ISR group and non-ISR group according to the results of coronary angiography.In this study,RDW was mainly measured by RDW-coefficient of variation(RDWCV)and RDW-standard deviation(RDW-SD).Results:A total of 203 people were included in this study,and 34 people developed DES-ISR between 9 and 12 months after intervention.The DES-ISR group had higher RDW-CV[(13.8±0.9)%vs.(13.0±0.7)%and RDW-SD(43.2±1.9)vs.(41.7±2.5)fL]than the non-DES-ISR group.After adjusting for traditional risk factors by multivariate regression analysis,RDW-CV(OR=3.105,95%CI:1.892-5.094,P<0.001)and RDW-SD(OR=1.347,95%CI:1.143-1.589,P<0.001)remained as the independent risk factor for DES-ISR.Furthermore,the receiver operating characteristic curve analysis also were constructed to confirm that RDW-CV and RDW-SD could effectively predict the risk of DES-ISR,and the areas under the curve were 0.789 and 0.703,respectively.Conclusions:In patients who underwent DES implantation successfully,RDW(RDW-CV and RDW-SD)was independently associated with the risk of ISR in medium-and long-term.