世居高原人群红细胞生理指标变化与冠状动脉慢血流现象的相关性分析

目的：探讨高原人群红细胞生理指标变化与冠状动脉慢血流现象（ CSFP）的相关性。方法选择高原人CSFP患者133例设为慢血流组，冠状动脉血流正常者137例，设为对照组，检测两组红细胞生理指标，并分析其与CSFP的关联性。结果单因素分析结果显示：慢血流组高血压、糖尿病病史、吸烟史以及男性比例高于对照组（ P＜0．05）；两组凝血酶原时间（PT）、D-二聚体（D-dimer）、红细胞计数（RBC）、Hb、红细胞压积（Hct）、平均红细胞体积（MCV）、红细胞分布宽度标准差（RDW-SD）、总胆红素（TBIL）、直接胆红素（DBIL）、甘油三酯（TG）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）水平比较，差异有统计学意义（P＜0．05），而两组间活化部分凝血酶原时间（APPT）、纤维蛋白原（Fib）、纤维蛋白原降解产物（ FDP）、白细胞计数（ WBC）、红细胞分布宽度变异系数（ RDW-CV）、血小板计数（ PLT）、间接胆红素（ IBIL）、TC、脂蛋白a Lp（a）]水平比较，差异均无统计学意义（P ＞0．05）。多因素logistic回归分析显示：吸烟、糖尿病、高血压、RBC、Hb、Hct、TG、LDL-C、是冠状动脉慢血流的危险因素（P ＜0．05），而 DBIL、HDL-C 是冠状动脉慢血流的保护因素（P ＜0．05）。结论高血压、糖尿病病史、吸烟史以及TG、LDL-C、RBC、Hb、Hct等指标升高是高原地区CSFP发生发展的独立危险因素。

Study on the relationship between the changes of physiological indexes of red blood cells and coronary slow flow phenomenon in the native of high altitude area

Objective To investigate the correlation between the changes of physiological indexes of erythrocyte and the coronary slow flow phenomenon ( CSFP ) of plateau people .Methods One hundred and thirty-three patients with CSFP were selected as CSFP group ,and 137 patients showed no obvious abnormality of concurrent coronary artery angiography were selected as control group .Correlation between the changes of physiological indexes of erythrocyte and the CSFP were analyzed .Results Univariate analysis showed that the history of high blood pressure ,diabetes ,smoking history ,and the male proportion of CSFP group were higher than those of the control group (P<0.05),and there were statistical significances in prothrombin time ,D-dimer,RBC,Hb,hematocrit(Hct),mean corpuscular volume ( MCV) ,red cell distribution width reported statistically as standard deviation ( RDW-SD ) , direct bilirubin ( DBIL ) , indirect bilirubin (IBIL),TG,LDL-C,and HDL-C index between the two groups(P<0.05).But there were no statistical significances in activated partial thromboplastin time(APPT),fibrinogen(Fib),fibrinogen degration products (FDP),WBC,RDW-CV,PLT,IBIL,TC,or lipoprotein(a) Lp(a)]between the two groups(P>0.05).Multi-factor logistic regression analysis showed that smoking ,diabetes,hypertension,RBC, HGB,HCT,TG,and LDL-C are risk factors for CSFP(P<0.05),while DBIL and HDL-C were protective factors of CSFP(P<0.05). Conclusion Hypertension,diabetes,smoking history,and the increase of TG,LDL-C,RBC,HGB and HCT index are independent risk factors for CSFP .