急性冠脉综合征患者红细胞分布宽度和超敏CRP的变化及临床意义

目的了解冠心病患者中斑块稳定组与不稳定组之间红细胞分布宽度（red blood cell distribution width,RDW）是否有差异,是否能成为早期识别急性冠脉综合征（acute coronary syndromes,ACS）的一个潜在标记物；同时研究血清超敏C反应蛋白（hs-CRP）,并探讨二者之间是否有联系。方法 213例患者根据临床症状、相关标准及造影结果分成ACS组、SAP组及对照组,测定每位患者的RDW、hs-CRP及血脂指标。结果 （1）ACS组RDW值显著高于SAP组及对照组,而SAP组与对照组之间无显著性差异；（2）ACS组hs-CRP显著高于SAP组及对照组,而SAP组与对照组之间无显著性差异；（3）多因素Longistic回归分析发现RDW水平与ACS之间存在独立的显著性相关关系；（4）RDW与血清hs-CRP呈显著性正相关。结论 ACS组患者RDW是明显升高的,提示RDW的升高可能参与斑块不稳定的进展过程,可能是反映斑块易损性的一个潜在标记物。

Changes and clinical significance of RDW and hs-CRP in patients with acute coronary syndrome

Objective To explore whether RDW levels are different between the group of stable plaque and the group of unstable plaque in coronary heart disease and whether they can become a potential marker in early identification of ACS. The study also studied hs-CRP to explore whether they are associated with each other. Methods Two hundred and thirteen patients based on clinical symptoms,relevant standards and results of angiography were assigned into ACS group,SAP group and control group. RDW,hs-CRP and lipid parameters of each patient was measured. Results RDW in the ACS group was significantly higher than that in the SAP group and control group,while the SAP group and the control group had no significant difference. Hs-CRP in the ACS group was significantly higher than that in the SAP group and the control group,while the SAP group and the control group had no significant difference. Multivariable logistic regression analysis showed a significant independent relation between RDW and the presence of ACS. RDW and serum hs-CRP showed a significant positive correlation. Conclusions RDW of ACS patients are significantly elevated,which suggests that elevated RDW may be involved in the progression of plaque instability,and may be a potential marker of plaque vulnerability.