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目的分析红细胞分布宽度(RDW)与急性冠脉综合征(ACS)冠脉病变严重程度及远期预后的相关性。方法选取2013年1月至2014年12月于惠州市第一人民医院接受住院治疗的206例急性冠脉综合征患者作为研究对象,根据患者的冠脉造影结果及是否存在心肌酶学变化分为ACS组(n=130)以及对照组(n=76),对比两组各生化指标、远期心血管不良事件发生情况、并对相关因素行Logistic回归分析。结果 ACS组患者在肌钙蛋白(c Tn I)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、心脏左室射血分数(LVEF)、左心房内径(LVED)等生化指标上均与对照组相差较大,且差异均有统计学意义(P<0.05)。ACS组RDW、NT-Pro BNP高于对照组,差异均有统计学意义[(12.98±0.54)%vs.(12.26±0.41)%,(490.21±100.48)ng/ml vs.(49.08±10.46)ng/ml,P<0.05)];ACS组心力衰竭的发生率远高于对照组(7.69%vs.1.32%),且心血管不良事件的总发生率也显著大于对照组(13.85%vs.2.63%),差异均有统计学意义(P<0.05)。经Logistic回归分析,NT-Pro BNP、LDL-C、Apo B以及RDW均是急性冠脉综合征病重的独立危险因素。结论红细胞分布宽度与急性冠脉综合征冠脉病变严重程度呈正相关性。
Objective To analyze the relationship between RDW and severity of coronary artery disease (ACS) and long-term prognosis in patients with acute coronary syndrome (ACS). Methods From January 2013 to December 2014 in Huizhou First People ’s Hospital, 206 patients with acute coronary syndrome were enrolled in the study. According to the results of coronary angiography and the presence of myocardial enzymology, the patients were divided into ACS group (n = 130) and control group (n = 76). The biochemical indexes and long-term cardiovascular adverse events were compared between the two groups. Logistic regression analysis was used to analyze the related factors. Results In ACS group, there was no significant difference in cTn I, TC, TG, LDL-C, HDL-C, Left ventricular ejection fraction (LVEF), left atrium diameter (LVED) and other biochemical indicators were significantly different from the control group, and the differences were statistically significant (P <0.05). The levels of RDW and NT-Pro BNP in ACS group were significantly higher than those in control group [(12.98 ± 0.54)% vs (12.26 ± 0.41)%, (490.21 ± 100.48) ng / ml vs. (49.08 ± 10.46) ng / ml, P <0.05). The incidence of heart failure in ACS group was significantly higher than that in control group (7.69% vs.1.32%), and the overall incidence of cardiovascular adverse events was also significantly higher than that in control group (13.85% vs. 2.63%), the differences were statistically significant (P <0.05). Logistic regression analysis showed that NT-Pro BNP, LDL-C, Apo B and RDW were both independent risk factors of acute coronary syndrome. Conclusion The distribution width of erythrocytes is positively correlated with the severity of coronary artery disease in patients with acute coronary syndrome.