目的：探讨高龄高血压患者红细胞分布宽度（RDW）与心房颤动的关系。方法选取341例住院治疗的年龄超过80岁的高血压患者，根据其是否有心房颤动史进行分组分析，研究两组患者 RDW 及血生化指标的变化情况，并对入选研究对象随访90 d，记录新发心房颤动情况。通过多因素分析研究确定 RDW 的影响因素及其与心房颤动的关系。结果心房颤动患者 RDW 水平明显高于无心房颤动的患者（13．96±1．41，13．54±1．34，t ＝2．579，P ＝0．010）；RDW（OR ＝1．177，95％CI：1037～1．213）及左房内径（OR ＝1．180，95％ CI：1．046～1．330）都是心房颤动的独立危险因子。多因素回归分结果显示血红蛋白水平（P ＝0．0001）、左室射血分数（P ＝0．026）、合并心房颤动（P ＝0．004）均是高血压患者 RDW 水平的独立影响因素。90 d 随访结果发现新发心房颤动（NOAF）组患者 RDW 水平较无 NOAF 组有升高的趋势，但差异无统计学意义（P ＞0．05）。结论高龄高血压患者 RDW 水平的变化与心房颤动密切相关，入院时 RDW 水平升高并不是高血压住院患者90 d 内新发心房颤动事件的独立预测因子。%Objective To explore the relationship between red blood cell distribution width(RDW)and atrial fibrillation in overaged people with hypertension.Methods All hypertensive patients over 80 years old were enrolled. Then we measured the biochemical parameter including RDW ,ultrasound parameter such as LVEF,analyzed the differ-ence between the two group according to with or without artial fibrillation.All enrolled patients were followed up to 90 days for new-onset atrial fibrillation.Multivariate regression was carried out to find out the independent risk factors. Results RDW in patients with atrial fibrillation was significantly higher than that without atrial fibrillation (1 3.96 ± 1 3.54 VS.1 .41 ±1 .34,t =2.579,P =0.01 0).Both RDW (OR =1 .1 77,95%CI:1 .037-1 .21 3)and left atrial diame-ter (OR =1 .1 80,95%CI:1 .046-1 .330)were independent risk factors for atrial fibrillation by Logstic regression.Multi-variate regression results showed that hemoglobin level (P =0.0001 ),left ventricular ejection ejection fraction (P =0.026),combined with atrial fibrillation (P =0.004)were the independent factors of RDW levels in patients with es-sential hypertension.The 90 day follow-up results showed that the RDW level in patients with NOAF was higher than that in the controlled group,but not statistically significant (P >0.05).Conclusion In aged hypertensive patients ,RDW levels increase with the existence of atrial fibrillation and various types of atrial fibrillation exist will cause increased RDW levels,but RDW level on admission is not an independent predictor for occurrence new-onset atrial fibrillation in 90 days for hospitalized hypertensive patients.
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