红细胞及血小板分布宽度在预测心肌梗死中的价值分析被引量：5

Predictive value about the distribution width of red blood cell and platelet in myocardial infarction

下载PDF

导出

摘要目的：探讨红细胞分布宽度（RDW ）和血小板分布宽度（PDW ）对心肌梗死的预测价值。方法收集2011年11月至2013年10月以心肌梗死收治入重庆医科大学北碚附属医院的85例患者，回归性分析在心肌梗死发作前1～3个月测定的RDW值和PDW值与同时期健康对照组27例体检者的差异。结果采用SPSS17．0进行统计分析。结果心肌梗死组患者RDW值为（47．92＆#177;7．56）％和PDW值为（15．75＆#177;3．55）％，明显高于对照组的RDW值[（42．65＆#177;2．40）％]和PDW值[（13．52＆#177;1．94）％]，差异有统计学意义（P＜0．05）。心肌梗死组患者RDW值分别与PDW值和年龄存在明显的线性正相关（ P＜0．05），且该组中女性 PDW值明显高于男性（ P＜0．01）。经多因素Logistic回归分析，RDW值和PDW值升高是发生心肌梗死的独立危险因素。RDW值预测发生心肌梗死的受试者工作特征曲线（ROC）下面积为0．767（95％ CI 0．692～0．842），临界值为44．8％，对应的预测灵敏度为64．3％，特异度为88．9％。PDW值预测发生心肌梗死的 ROC下面积为0．675（95％ CI 0．583～0．766），临界值为14．9％，对应预测灵敏度为61．2％，特异度为58．1％。结论 RDW值和PDW值能较好地预测心肌梗死的发病风险。 Objective To explore the predictive value of red blood cell distribution width （RDW） and platelet distribution width（PDW） in myocardial infarction .Methods Eighty five patients with myocardial infarction in Beibei Affiliated Hospital of Chongqing Medical University were selected as myocardial infarction group （MI group） ,in which RDW ,PDW had been detected one to three months before attack and compared with those of the control group included 27 healthy persons .SPSS17 .0 was used to analyze the results .Results The RDW ,PDW levels of MI group were （47 .92% ＆#177; 7 .56% ,P＆lt;0 .01） ,（15 .75% ＆#177; 3 .55% ,P＆lt;0 .05）respectively ,which were significantly higher than those of the control group which were（42 .65% ＆#177; 2 .40% ） ,（13 .52% ＆#177; 1 .94% ）respectively .Pearson correlation a-nalysis showed that PDW level（P＆lt;0 .05）and age（P＆lt;0 .05）had positive correlation with RDW level in MI group . An independent sample test showed that PDW level of women was significantly higher than that of Men in MI group （P＆lt;0 .01） .In multivariate Logistic analyses ,higher levels of PDW and RDW were independent risk factors of myo-cardialinfarction.Theareaunderreceiveroperatingcharacteristicscurve（AUC）ofpredictionmyocardialinfarctionof RDW level was 0 .767（95% CI 0 .692-0 .842） ,the corresponding Cut-off point was 44 .8% with sensitivity 64 .3%and specificity 88 .9% .The AUC of prediction myocardial infarction of PDW level was 0 .675（95% CI 0 .583 -0 .766） ,the corresponding Cut-off point was 14 .9% with sensitivity 61 .2% and specificity 58 .1% .Conclusion RDW and PDW could be a good predictive marker for myocardial infarction .

作者张明昊刘佳高常夏春慧幸艺芳熊娅张雪晶蔡晓钟

机构地区重庆医科大学实验教学管理中心重庆医科大学公共卫生与管理学院

出处《检验医学与临床》 CAS 2014年第5期597-600,共4页 Laboratory Medicine and Clinic

关键词心肌梗死红细胞分布宽度血小板分布宽度动脉粥样硬化心肌缺血 myocardial infarction red blood cell distribution width platelet distribution width athero-sclerosis ischemia myocardial

分类号 R446.11 [医药卫生—诊断学]

引文网络
相关文献

参考文献12

1Felker GM,Allen LA,Pocock SJ,et al.Red cell distribu-tion width as a novel prognostic marker in heart failure:data from the CHARM Program and the Duke Databank[J].J Am Coll Cardiol,2007,50(1):40-47.
2Dabbah S,Hammerman H,Markiewicz W,et al.Relationbetween red cell distribution width and clinical outcomesafter acute myocardial infarction[J].Am J Cardiol,2010,105(3):312-317.
3Sangoi MB,Da Silva SH,da Silva JE,et al.Relation be-tween red blood cell distribution width and mortality afteracute myocardial infarction[J].Int J Cardiol,2011,146(2):278-282.
4Akin F,Kose N,Ayva B,et al.Relation between red celldistribution width and severity of coronary artery diseasein patients with acute myocardial infarction[J].Angiolo-gy,2013,64(8):592-596.
5Ihara A,Kawamoto T,Matsumoto K,et al.Relationshipbetween hemostatic factors and the platelet index in pa-tients with ischemic heart disease[J].Pathophysiol Hae-most Thromb,2006,35(5):388-391.
6张桂,石庆新,许成新.急性心肌梗死检测D-二聚体和超敏C反应蛋白临床意义的Meta分析[J].中国卫生检验杂志,2011,21(5):1205-1206. 被引量：13
7Thygesen K,Alpert JS.Jaffe AS,et al.Third Universaldefinition of myocardial infarction[J].Eur Heart J,2012,33(20):2551-2567.
8颜俊青,邢俊,宋星宇.PLT、PCT、MPV、PDW在冠心病诊断和治疗中的临床价值[J].海南医学,2012,23(17):90-91. 被引量：13
9Nesbitt WS,Westein E,Tovar-Lopez FJ? et al.A sheargradient-dependent platelet aggregation mechanism drivesthrombus formation[J].Nat Med,2009,15(6):665-673.
10Vagdatli E,Gounari E,Lazaridou E,et al.Platelet distri-bution width:a simple,practical and specific marker of ac-tivation of coagulation[J].Hippokratia,2010,14(1):28-32.

二级参考文献19

1田文洪.冠心病患者血小板参数的变化及临床意义[J].实用临床医学（江西）,2004,5(3):43-43. 被引量：14
2Lowe GD, Stwcctnam PM, Yamell JW, et al. C - reactiveprotein, fibrin, D - dimer and risk of isehemic heart disease : theCaerphilly and speed- well studies [ J ]. Arierioscler Thromb Vasc Biol, 2004,24 ( 10 ) : 1957 - 1962.
3Bhagat S, Gaiha M, Sharma VK, et al. A comparative evaluation of C - reactive protein as a short - term prognostic marker in severe unstable angina - a preliminary study [J]. J Assoc Physieians India, 2003,51 (4) :349 -354.
4] Turgut U, Huseyin S. Looking for our ten years resuhs for coronaryheart disease and ischecnic storke group for the standpoint othaemostasis [ J ]. Turk J Haematol,2002,19:255 - 263.
5Osman R,L'Allier PL ,Elgharib N ,et al. Critical appraisal of C -reactive protein throughout the spectrum of cardiovascular disease [ J ]. Vascular Health and Risk Management,2006,2(3):221.
6Bosevski M, Kostoska S ,Tosev S, et al. Usefulness of D2Dimers and fibrinogen plasma determination in patient s wit h polyvascular disease [ J ]. Augiol Sosud Khir,2006,12 ( 2 ) :9215.
7Arroyo - Espliguero R, Avanzas P, Cosin - Sales J, et al. C - reactive protein elevation and disease activity in patients with coronary artery disease[J]. Eur Heart J,2004,25(5) :401 -408.
8Haidari M, Javadi E, Sadeghi B, et al. Evaluation of C - reactive protein, asensitive marker of inflammation, as a risk factor for stalble coronary artery disease[J]. Clin Biochem,2001,34(4) :309 -315.
9国际心脏病学会和协会及世界卫生组织临床命名标准化联合专题组报告.缺血性心脏病的命名及诊断标准[J].中华心血管病杂志,1981,9(1):75-76.
10谭齐肾.临床血液学和血液检验[M].3版.北京:人民卫生出版社.2006:1.