红细胞分布宽度在急性冠脉综合征患者非罪犯病变斑块进展中的预测作用

Predictive value of red blood cell distribution width in progression of non-culprit plaque in patients with acute coronary syndrome

摘要:

目的 评估红细胞分布宽度（RDW）等指标在预测急性冠脉综合征（ACS）患者非罪犯病变斑块进展中的价值。方法 入选2008年8月1日至2013年8月1日在解放军总医院心脏介入中心行经皮冠状动脉介入治疗（PCI）术的ACS患者421例。根据三维定量冠状动脉造影（3D-QCA）分析斑块进展与否，将所有患者分为两组：进展组（n=109）和非进展组（n=312）。比较两组患者相关临床资料、传统危险因素的差异，并通过logistic回归分析探讨RDW和其他危险因素与非罪犯斑块进展之间的关系。结果 与非进展组相比，进展组患者RDW显著增高［（13.08±0.73）% vs （12.89±0.71）%，P=0.020］。RDW四分位分组分析斑块进展结果也表明，随RDW的升高，非罪犯病变血管斑块进展在各组中所占的比例也呈升高趋势，且两两比较差异均具有统计学意义（P＜0.05）。经校正后的多因素回归分析显示RDW（OR=1.385，P=0.045）和糖尿病（OR=1.809，P=0.026）是病变进展的独立危险因素。结论 RDW能够在一定程度上预测ACS患者非罪犯病变斑块的进展。

Abstract:

Objective To assess the value of red blood cell distribution width (RDW) in predicting the progression of non-culprit plaque in the patients with acute coronary syndrome (ACS). Methods A total of 421 ACS patients who underwent percutaneous coronary intervention (PCI) in our center of cardiac intervention from 1st August 2008 to 1st August 2013 were enrolled in this study. According to the results of plaque progression by 3D-quantitative coronary angiography (3D-QCA), the patients were divided into the progression group (n=109) and the non-progression group (n=312). The related clinical data and traditional risk factors of coronary disease were compared to evaluate the relationship between RDW and the progression of non-culprit plaque by logistic regression analysis. Results Compared with the non-progression group, the progression group had obvious higher values of RDW ［(13.08±0.73)% vs (12.89±0.71)%, P=0.020)］. The analysis on the plaque progression in the quartile subgroups of RDW indicated that there were more patients with progression of non-culprit lesion in the higher quartile subgroup of RDW (P<0.05). Multivariate regression analysis revealed that RDW (adjusted OR=1.385, P=0.045) and diabetes (adjusted OR=1.809, P=0.026) were 2 independent risk factors for predicting the progression of non-culprit lesion in the patients with ACS. Conclusion RDW can predict the progression of non-culprit plaque in the ACS patients to some extent.