嗜酸性粒细胞计数和红细胞分布宽度预测冠状动脉慢血流发生的预测价值

目的观察冠状动脉慢血流(coronary slow flow,CSF)的临床特点,探讨嗜酸性粒细胞计数和红细胞分布宽度对CSF发生的预测价值。方法因胸痛行冠状动脉造影检查的315例患者,根据冠状动脉血流情况分为2组,CSF患者87例为CSF组,冠状动脉血流正常者228例为对照组。比较2组一般资料、实验室指标;多因素logistic回归分析CSF发生的影响因素;绘制ROC曲线,评估嗜酸性粒细胞计数和红细胞分布宽度对CSF发生的预测效能。结果CSF组男性比率(69.0%)、吸烟比率(54.0%)、嗜酸性粒细胞计数(0.18±0.06)×10⁹/L]、红细胞分布宽度(12.18±1.06)%]均高于对照组40.4%、25.0%、(0.11±0.05)×10⁹/L、(11.12±0.85)%](P<0.05)。吸烟(OR=3.266,95%CI:1.687~6.074,P=0.002)、红细胞分布宽度(OR=2.266,95%CI:1.087~4.096,P=0.004)和嗜酸性粒细胞计数(OR=7.767,95%CI:4.634~12.350,P<0.001)是CSF发生的影响因素。红细胞分布宽度、嗜酸性粒细胞计数的最佳截断值分别为12.8%、0.19×10⁹/L时,预测CSF发生的AUC分别为0.735(95%CI:0.638~0.835,P=0.030)、0.876(95%CI:0.842~0.916,P=0.040),灵敏度分别为50.4%、95.6%,特异度分别为86.7%、64.5%。结论CSF多见于男性和吸烟患者,嗜酸性粒细胞计数和红细胞分布宽度对CSF发生有一定的预测价值。

Values of eosinophil count and red blood cell distribution width to the prediction of coronary slow flow

Objective To observe the clinical characteristics of coronary slow flow(CSF)and investigate the values of eosinophil count and red blood cell distribution width(RDW)to the prediction of CSF.Methods Totally 315patients received coronary angiography due to chest pain,and were divided into CSF group(n=87)and control group(n=228)according to the coronary blood flow results.The general data and laboratory indexes were detected and compared between two groups.Multivariate logistic regression analysis was used to assess the influencing factors of CSF.ROC was drawn to analyze the values of eosinophil count and RDW to the prediction of CSF.Results The ratio of male patients,percentage of smoking,eosinophil count and RDW were higher in CSF group(69.0%,54.0%,(0.18±0.06)×10⁹/L,(12.18±1.06)%)than those in control group(40.4%,25.0%,(0.11±0.05)×10⁹/L,(11.12±0.85)%)(P<0.05).Smoking(OR=3.266,95%CI:1.687-6.074,P=0.002),RDW(OR=2.266,95%CI:1.087-4.096,P=0.004)and eosinophil count(OR=7.567,95%CI:4.634-12.350,P<0.001)were the influencing factors of CSF.When the optimal cut-offvalues of RDW and eosinophil count were 12.8%and 0.19×10⁹/L,the AUCs for predicting CSF were 0.735(95%CI:0.638-0.835,P=0.030)and 0.876(95%CI:0.842-0.916,P=0.040),the sensitivities were 50.4%and 95.6%,and the specificities were 86.7%and 64.5%,respectively.Conclusion CSF occurs mainly in male and smoking patients.The increased eosinophil count and RDW have certain values to the prediction of CSF.