红细胞分布宽度与房颤患者脑血栓栓塞风险相关性研究(1)
[摘要]目的 探究房颤患者红细胞分布宽度(RDW)与血栓栓塞风险间的相关性。方法 选取2016年7月～2017年6月石城县人民医院收治的186例非瓣膜性房颤患者作为研究对象，采用CHADS2/CHA2DS2-VASc评分判断患者发生血栓栓塞的危险性，根据评分结果分为血栓栓塞高危组(评分≥2分)和低危组(评分<2分)，行肘静脉穿刺采集患者外周血进行血常规检查，获取两组患者的RDW值，随访半年，以头颅磁共振来判断脑梗塞的情况。对比两组RDW值的差异，比较两组脑梗塞的发生情况，并分析RDW值与血栓栓塞风险间的相关性。结果 高危组的RDW值高于低危組，差异有统计学意义(P<0.05)；高危组有症状脑梗死、无症状脑梗死发生率均明显高于低危组，差异有统计学意义(P<0.05)。以房颤RDW值、性别为自变量，以CHADS2/CHA2DS2-VASc高分预测结果为因变量，采取多因素Logistic回归分析，结果显示，在95%可信区间，OR值>1，β值>0，提示RDW与CHADS2/CHA2DS2-VASc高分预测成正相关(P<0.05)。结论 房颤患者测定RDW与CHADS2/CHA2DS2-VASc高分预测成正相关，提示RDW有可能成为预测房颤患者血栓栓塞风险的指标，且相比CHADS2/CHA2DS2-VASc评分预测更加便捷、客观。
[关键词]非瓣膜性房颤；红细胞分布宽度；血栓栓塞；相关性
[中图分类号] R541.75 [文献标识码] A [文章编号] 1674-4721(2018)11(a)-0044-03
Analysis of the relationship between red blood cell distribution width and risk of thromboembolism in patients with atrial fibrillation
HUANG Yun-qiang WEI Biao-song
Department of Internal Medicine， People′s Hospital of Shicheng County in Jinagxi Province， Shicheng 342700， China
[Abstract] Objective To explore the correlation between red blood cell distribution width (RDW) and thromboembolic risk in patients with atrial fibrillation. Methods A total of 186 patients with non valvular atrial fibrillation treated in People′s Hospital of Shicheng County from July 2016 to June 2017 were selected as the subjects. The risk of thromboembolism was determined by CHADS2/CHA2DS2-VASc score. According to the score， the patients were divided into high risk group of thromboembolism (score≥2 pionts) and low risk group (score<2 points). The peripheral blood was collected by the elbow vein puncture for blood routine examination， and the RDW value of two groups of patients was obtained. The follow-up was half a year， and the cerebral infarction was judged by cranial magnetic resonance. The difference of RDW values between the two groups was compared， the occurrence of cerebral infarction in two groups was compared， and the correlation between RDW value and thromboembolic risk was analyzed. Results The RDW value in the high risk group was significantly higher than that in the low risk group， the difference was statistically significant (P<0.05). The incidence of symptomatic cerebral infarction and asymptomatic cerebral infarction in high risk group was significantly higher than that in the low risk group， the difference was statistically significant (P<0.05). With the RDW value and gender as the independent variable， and the CHADS2/CHA2DS2-VASc high score prediction result as the dependent variable， the multiple factor Logistic regression analysis was adopted. The results showed that in the 95% confidence interval， the OR value > 1 and the β value > 0，which showed a positive correlation between the RDW and the CHADS2/CHA2DS2-VASc high score prediction (P<0.05). Conclusion There is a positive correlation between the measurement of red blood cell distribution width and CHADS2/CHA2DS2-VASc high score prediction in patients with atrial fibrillation， indicating that RDW may be an indicator of thromboembolism risk in patients with atrial fibrillation， and it is more convenient and objective compared with the CHADS2/CHA2DS2-VASc score., http://www.100md.com(黄运强 魏标松)
[关键词]非瓣膜性房颤；红细胞分布宽度；血栓栓塞；相关性
[中图分类号] R541.75 [文献标识码] A [文章编号] 1674-4721(2018)11(a)-0044-03
Analysis of the relationship between red blood cell distribution width and risk of thromboembolism in patients with atrial fibrillation
HUANG Yun-qiang WEI Biao-song
Department of Internal Medicine， People′s Hospital of Shicheng County in Jinagxi Province， Shicheng 342700， China
[Abstract] Objective To explore the correlation between red blood cell distribution width (RDW) and thromboembolic risk in patients with atrial fibrillation. Methods A total of 186 patients with non valvular atrial fibrillation treated in People′s Hospital of Shicheng County from July 2016 to June 2017 were selected as the subjects. The risk of thromboembolism was determined by CHADS2/CHA2DS2-VASc score. According to the score， the patients were divided into high risk group of thromboembolism (score≥2 pionts) and low risk group (score<2 points). The peripheral blood was collected by the elbow vein puncture for blood routine examination， and the RDW value of two groups of patients was obtained. The follow-up was half a year， and the cerebral infarction was judged by cranial magnetic resonance. The difference of RDW values between the two groups was compared， the occurrence of cerebral infarction in two groups was compared， and the correlation between RDW value and thromboembolic risk was analyzed. Results The RDW value in the high risk group was significantly higher than that in the low risk group， the difference was statistically significant (P<0.05). The incidence of symptomatic cerebral infarction and asymptomatic cerebral infarction in high risk group was significantly higher than that in the low risk group， the difference was statistically significant (P<0.05). With the RDW value and gender as the independent variable， and the CHADS2/CHA2DS2-VASc high score prediction result as the dependent variable， the multiple factor Logistic regression analysis was adopted. The results showed that in the 95% confidence interval， the OR value > 1 and the β value > 0，which showed a positive correlation between the RDW and the CHADS2/CHA2DS2-VASc high score prediction (P<0.05). Conclusion There is a positive correlation between the measurement of red blood cell distribution width and CHADS2/CHA2DS2-VASc high score prediction in patients with atrial fibrillation， indicating that RDW may be an indicator of thromboembolism risk in patients with atrial fibrillation， and it is more convenient and objective compared with the CHADS2/CHA2DS2-VASc score., http://www.100md.com(黄运强 魏标松)