红细胞分布宽度、平均血小板体积与早发冠心病的相关性

目的探讨红细胞分布宽度(RDW)、平均血小板体积(MPV)在早发冠心病人群中的分布特征及其与冠状动脉病变严重程度的关系,评价RDW、MPV对早发冠心病的诊断价值。方法收集因胸痛发作疑诊冠心病且男性55岁、女性65岁的患者407例,经冠状动脉造影(CAG)确诊早发冠心病组309例,余98例为正常对照组。比较2组及早发冠心病各疾病亚组间的RDW、MPV水平,分析RDW、MPV与冠状动脉病变严重程度(Gensini评分)的相关性及早发冠心病的独立危险因素。结果早发冠心病组RDW、MPV水平明显高于正常对照组(P0.05),RDW、MPV在急性心肌梗死(AMI)组、不稳定型心绞痛(UAP)组和稳定型心绞痛(SAP)组均高于正常对照组(P0.05)。早发冠心病组RDW、MPV与Gensini评分之间存在正相关(r分别为0.246、0.199,P0.05);多因素Logistic回归分析显示RDW(OR=3.373,95%CI:2.197～6.359,P0.001)和MPV(OR=1.353,95%CI:1.074～1.705,P=0.010)是早发冠心病的独立危险因素。R0C曲线分析发现,RDW诊断早发冠心病的界点值为12.25%(敏感性69%,特异性72%),MPV诊断早发冠心病的界点值为8.55 fl(敏感性91%,特异性37%)。结论 RDW、MPV与早发冠心病的临床类型及冠状动脉病变的严重程度有关,是早发冠心病的独立危险因素,为早发冠心病的诊断提供一定依据。

Correlation between red blood cell distribution width,mean platelet volume and premature coronary artery disease

Aim To investigate the distribution of red blood cell distribution width (RDW) and mean platelet volume (MPV) in patients with premature coronary artery disease(PCHD) and its relationship with the severity of PCHD, and to evaluate the diagnostic value of RDW and MPV for PCHD. Methods A total of 407 patients with suspected coronary artery disease(CHD) due to chest pain and male <55 years old and female <65 years old were enrolled in the study. All patients received coronary angiography (CAG), 309 cases of PCHD were confirmed and the remaining 98 cases were normal control group. The levels of RDW and MPV in the two groups and the subgroups of the PCHD were compared. The correlation between RDW and MPV and severity of coronary lesions (Gensini score) and independent risk factors for PCHD were analyzed. Results The levels of RDW and MPV in the PCHD group were significantly higher than those in the control group (P<0.05). RDW and MPV were higher in the acute myocardial infarction (AMI), unstable angina pectoris (UAP) and stable angina pectoris (SAP) groups than the control group (P<0.05); there was a positive correlation between RDW, MPV and Gensini scores in the PCHD group(r=0.246 and 0.199, P<0.05). Multivariate Logistic regression analysis showed that RDW and MPV were independent risk factors for PCHD(OR=3.3,5%CI:2.197~6.359, P<0.001; OR=1.3,5%CI:1.074~1.705, P=0.010). R0C curve analysis showed that the optimal cut-off value of RDW to diagnose PCHD was 12.25% with a sensitivity of 69% and specificity of 72%, and the optimal cut-off value of MPV to diagnose PCHD was 8.55 fl with a sensitivity of 91% and a specificity of 37%. Conclusions RDW and MPV are correlated to the clinical type of PCHD and the severity of PCHD. RDW and MPV are the independent risk factors for PCHD, which provides some value for the diagnosis of PCHD.