老年脑梗死患者颈动脉粥样硬化斑块稳定性与红细胞分布宽度的关系

目的探讨老年脑梗死患者颈动脉粥样硬化斑块稳定性与红细胞分布宽度(red blood cell distribution width,RDW)之间的相关性。方法选择老年急性脑梗死伴颈动脉粥样硬化斑块患者165例,按颈动脉彩色超声结果,分为稳定斑块组45例和不稳定斑块组120例。收集一般临床资料及心血管病危险因素,测定体重指数、踝臂指数、血脂、糖化血红蛋白、肌酐、白细胞、血红蛋白、RDW、红细胞体积、高敏C反应蛋白(high sensitivity C-reactive pro-tein,hs-CRP)、血浆纤维蛋白原(fibrinogen,Fib)等,并进行组间比较。结果与稳定斑块组比较,不稳定斑块组RDW、hs-CRP、Fib明显增高,差异有统计学意义(P<0.05,P<0.01)。Spearman相关分析显示,颈动脉不稳定斑块与RDW(r=0.244,P<0.01)、hs-CRP(r=0.323,P<0.01)、Fib(r=0.164,P<0.05)呈正相关。logistic回归分析显示,校正性别、年龄及其他传统危险因素后,RDW为颈动脉不稳定斑块的危险因素(OR=2.020,95%CI:1.191～3.426,P<0.01)。结论老年脑梗死患者颈动脉粥样硬化斑块稳定性与RDW相关,RDW增高患者颈动脉粥样硬化斑块破裂的风险增加。

Relation between carotid atherosclerotic plaque stability and red blood cell distribution width in elderly cerebral infarction patients

Objective To study the relation between carotid atherosclerotic plaque stability and red blood cell distribution width(RDW) in elderly cerebral infarction patients.Methods One hundred and sixty-five elderly acute cerebral infarction(ACI) patients with carotid plaques were divided into stable plaque group(n=45) and unstable plaque group(n=120) according to their color Doppler ultrasonography.Their clinical data and risk factors for cardiovascular diseases were collected,their serum levels of lipid,hemoglobin,A1c,createnine,plasma fibrinogen(Fib),hs-CRP and mean corpusculal volume were measured,and their body mass index,ankle brachial index,white blood cells and RDW were detected.Results The RDW and serum levels of hs-CRP and Fib were significantly higher in unstable plaque group than in stable plaque group(P<0.05,P<0.01).Spearman correlation analysis showed that the incidence of unstable carotid plaques was positively correlated with RDW(r=0.244,P<0.01),hs-CRP(r=0.323,P<0.01) and Fib(r=0.164,P<0.05).Logistic regression analysis demonstrated that RDW was the risk factor for unstable plaques after adjustment for age,sex and other traditional cardiovascular risk factors(OR=2.020,95%CI:1.191-3.426,P<0.01).Conclusion RDW is related with the stability of carotid atherosclerotic plaques and increases the risk of plaque rupture in elderly ACI patients.