目的 探讨冠心病患者的红细胞体积分布宽度(RDW)与冠心病的关系.方法 收集2011年1月-2012年6月在我院住院的冠心病患者224例(冠心病组),其中心绞痛患者110例(稳定性心绞痛24例、不稳定性心绞痛86例)、急性心肌梗死患者114例;另选取同期冠状动脉造影结果正常者81例作为对照组.对所有入选者测定RDW、血红蛋白(HGB)、红细胞计数(RBC)、白细胞计数(WBC)、红细胞平均体积(MCV)、血细胞比容(Hct)、血小板计数(PLT)、平均血小板体积(MPV)、尿素氮(BUN)、血肌酐(Cr)、血尿酸(UA)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、清蛋白、血脂水平,并对两组进行对比分析.根据冠状动脉造影结果对冠心病组进行Gensini积分评价,并分析Gensini积分与RDW是否有相关性.应用多元Logistic回归分析预测冠心病的独立危险因素.结果 与对照组比较,冠心病组RDW升高[(12.38±0.64)%与(12.17±0.45)%],差异有统计学意义(P＜0.01).Pearson相关分析显示,RDW与年龄、BUN、Cr、Gensini积分呈正相关,相关系数r分别为0.233、0.222、0.120、0.199,P均＜0.01.多元线性回归分析显示,年龄、Gensini积分为RDW的独立影响因素.多元 Logistic 回归分析显示,预测冠心病的独立影响因素包括:吸烟、糖尿病、RDW和三酰甘油.结论 RDW与冠心病冠状动脉狭窄程度有关,是冠心病的独立影响因素.%Objective To analyze the relationship between red blood cell distribution width ( RDW ) and coronary artery disease ( CAD ). Methods RDW, hemoglobin ( HGb ), red blood cell count ( RBC ), white blood cell count ( WBC ), mean corpuscular volume ( MCV ), hematocrit ( Hct), platelet count ( PLT ), mean platelet volume ( MPV ), blood urea nitrogen ( BUN ), serum creatinine ( Cr ), blood uric acid ( UA ), alanine aminotransferase enzyme ( ALT ), aspartate amin-otransferase ( AST), albumin, blood lipids were determined in 81 healthy subjects ( control group ) and 224 CAD patients ( CAD group ) including 110 patients with angina pectoris and 114 with acute myocardial infarction. The results were analyzed comparatively; Gensini score performed in CAD group based on coronary angiography; the correlation of Gensini score with RDW analyzed. Multivariate logistic regression analysis was used to evaluate the independent risk factors of CAD. Results As compared with control group, RDW increased in CAD group, the difference was significant [ ( 12.38 ?.64 )% vs. ( 12. 17 ?.45 )% , P <0. 01 ]. By pearson correlation analysis, RDW was positively correlated with age, BUN, Cr, Gensini score ( r- 0.233, 0.222, 0. 120, 0. 199; P all < 0.01 ). Multiple linear regression analysis showed that age, Gensini score were independent influencing factors of RDW. Multivariate logistic regression analysis showed that the independent risk factors predicting CAD included smoking, diabetes, RDW and TG. Conclusion RDW, associated with the severity of coronary artery stenosis, is an independent influencing factor for CAD.
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