检验医学与临床
檢驗醫學與臨床
검험의학여림상
Laboratory Medicine and Clinic
2015年
20期
3019-3022
,共4页
红细胞体积分布宽度%超敏C反应蛋白%冠心病%冠状动脉造影
紅細胞體積分佈寬度%超敏C反應蛋白%冠心病%冠狀動脈造影
홍세포체적분포관도%초민C반응단백%관심병%관상동맥조영
red blood cell distribution width%high sensitivity C-reactive protein%coronary heart disease%coronary angiography
目的:探讨红细胞体积分布宽度(RDW)和超敏C反应蛋白(hs‐CRP)与冠心病的相关性。方法选取冠心病患者146例为冠心病组,选择同期健康体检者70例为对照组。根据疾病类型,将冠心病组分为稳定性心绞痛(SAP)组66例,不稳定性心绞痛(UAP)组53例,急性心肌梗死(AMI)组27例。根据病变支数分组,将冠心病组分为单支病变组65例,双支病变组48例,多支病变组33例。对所有研究对象分别检测RDW、红细胞平均体积(MCV)、血细胞比容(Hct)、血小板计数(PLT)和平均血小板体积(MPV)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、总胆固醇(TC)、三酰甘油(TG)、肌酐(Cr)、尿素氮(BUN)、尿酸(UA)、葡萄糖(GLU)、总胆红素(TBIL)及hs‐CRP水平。应用ROC曲线评价RDW和hs‐CRP对冠心病的诊断价值,应用多元Logistic回归分析预测冠心病的独立危险因素。结果与对照组比较,冠心病组LDL、hs‐CRP及RDW水平明显升高(P<0.05)。AMI组血清hs‐CRP和RDW水平明显高于SAP组(P<0.01),且 AMI组血清hs‐CRP水平明显高于 UAP组(P<0.05)。多支病变组血清hs‐CRP和RDW水平明显高于单支病变组和双支病变组(P<0.01),且双支病变组RDW水平明显高于单支病变组(P<0.05)。RDW和hs‐CRP的ROC曲线下面积(AUC)分别为0.769(95% CI:0.683~0.842)、0.732(95% CI:0.656~0.820)。RDW和hs‐CRP的最佳临界值分别为14.65%和5.92 mg/L ,这时的灵敏度和特异度分别为75.8%、61.7%和74.5%、62.1%。多元Logistic回归分析显示,RDW、HDL、吸烟史和性别进入回归模型,回归系数分别为0.624、-7.254、0.630、0.947。结论 RDW和hs‐CRP与冠状动脉病变和冠心病病情的严重程度有关,高水平的RDW可能是冠心病的独立影响因素。
目的:探討紅細胞體積分佈寬度(RDW)和超敏C反應蛋白(hs‐CRP)與冠心病的相關性。方法選取冠心病患者146例為冠心病組,選擇同期健康體檢者70例為對照組。根據疾病類型,將冠心病組分為穩定性心絞痛(SAP)組66例,不穩定性心絞痛(UAP)組53例,急性心肌梗死(AMI)組27例。根據病變支數分組,將冠心病組分為單支病變組65例,雙支病變組48例,多支病變組33例。對所有研究對象分彆檢測RDW、紅細胞平均體積(MCV)、血細胞比容(Hct)、血小闆計數(PLT)和平均血小闆體積(MPV)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、總膽固醇(TC)、三酰甘油(TG)、肌酐(Cr)、尿素氮(BUN)、尿痠(UA)、葡萄糖(GLU)、總膽紅素(TBIL)及hs‐CRP水平。應用ROC麯線評價RDW和hs‐CRP對冠心病的診斷價值,應用多元Logistic迴歸分析預測冠心病的獨立危險因素。結果與對照組比較,冠心病組LDL、hs‐CRP及RDW水平明顯升高(P<0.05)。AMI組血清hs‐CRP和RDW水平明顯高于SAP組(P<0.01),且 AMI組血清hs‐CRP水平明顯高于 UAP組(P<0.05)。多支病變組血清hs‐CRP和RDW水平明顯高于單支病變組和雙支病變組(P<0.01),且雙支病變組RDW水平明顯高于單支病變組(P<0.05)。RDW和hs‐CRP的ROC麯線下麵積(AUC)分彆為0.769(95% CI:0.683~0.842)、0.732(95% CI:0.656~0.820)。RDW和hs‐CRP的最佳臨界值分彆為14.65%和5.92 mg/L ,這時的靈敏度和特異度分彆為75.8%、61.7%和74.5%、62.1%。多元Logistic迴歸分析顯示,RDW、HDL、吸煙史和性彆進入迴歸模型,迴歸繫數分彆為0.624、-7.254、0.630、0.947。結論 RDW和hs‐CRP與冠狀動脈病變和冠心病病情的嚴重程度有關,高水平的RDW可能是冠心病的獨立影響因素。
목적:탐토홍세포체적분포관도(RDW)화초민C반응단백(hs‐CRP)여관심병적상관성。방법선취관심병환자146례위관심병조,선택동기건강체검자70례위대조조。근거질병류형,장관심병조분위은정성심교통(SAP)조66례,불은정성심교통(UAP)조53례,급성심기경사(AMI)조27례。근거병변지수분조,장관심병조분위단지병변조65례,쌍지병변조48례,다지병변조33례。대소유연구대상분별검측RDW、홍세포평균체적(MCV)、혈세포비용(Hct)、혈소판계수(PLT)화평균혈소판체적(MPV)、고밀도지단백(HDL)、저밀도지단백(LDL)、총담고순(TC)、삼선감유(TG)、기항(Cr)、뇨소담(BUN)、뇨산(UA)、포도당(GLU)、총담홍소(TBIL)급hs‐CRP수평。응용ROC곡선평개RDW화hs‐CRP대관심병적진단개치,응용다원Logistic회귀분석예측관심병적독립위험인소。결과여대조조비교,관심병조LDL、hs‐CRP급RDW수평명현승고(P<0.05)。AMI조혈청hs‐CRP화RDW수평명현고우SAP조(P<0.01),차 AMI조혈청hs‐CRP수평명현고우 UAP조(P<0.05)。다지병변조혈청hs‐CRP화RDW수평명현고우단지병변조화쌍지병변조(P<0.01),차쌍지병변조RDW수평명현고우단지병변조(P<0.05)。RDW화hs‐CRP적ROC곡선하면적(AUC)분별위0.769(95% CI:0.683~0.842)、0.732(95% CI:0.656~0.820)。RDW화hs‐CRP적최가림계치분별위14.65%화5.92 mg/L ,저시적령민도화특이도분별위75.8%、61.7%화74.5%、62.1%。다원Logistic회귀분석현시,RDW、HDL、흡연사화성별진입회귀모형,회귀계수분별위0.624、-7.254、0.630、0.947。결론 RDW화hs‐CRP여관상동맥병변화관심병병정적엄중정도유관,고수평적RDW가능시관심병적독립영향인소。
Objective To investigate the correlation between the red blood cell distribution width (RDW) and high sensitive C reactive protein(hs‐CRP) with coronary heart disease(CHD) .Methods 146 cases of CHD were se‐lected as the CHD group and divided into the stable angina pectoris (SAP) group(66 cases) ,unstable angina pectoris (UAP) group(53 cases) and acute myocardial infarction (AMI) group(27 cases) .Contemporaneous 70 cases of healthy physical examination were selected as the control group .RDW ,Hb ,RBC count ,WBC count ,MCV ,Hct , PLT ,MPV ,HDL ,LDL ,TC ,TG ,Cr ,BUN ,UA ,GLU ,TBIL and hs‐CRP levels were detected in each group .The ROC curve was adopted to evaluate the diagnostic value of RDW and hs‐CRP to CHD and the multivariate Logistic regression analysis was applied to predict the independent risk factors of CHD .Results Compared with the control group ,LDL ,hs‐CRP and RDW levels in the CHD group were increased significantly ,the differences were statistically significant(P<0 .05) .Serum hs‐CRP and RDW levels in the AMI group were significantly higher than those in the SAP group(P< 0 .01) ,moreover serum hs‐CRP level was significantly higher than that in the UAP group (P<0 .05) .The serum hs‐CRP and RDW levels in the multi vessels lesion group were significantly higher than those in the single vessel lesion group and double vessels lesion group (P<0 .01) ,moreover the RDW level in the double ves‐sels lesion group was significantly higher than that in the single vessel disease group (P<0 .05) .The area under curve (AUC) of ROC curves of RDW and hs‐CRP were that and 95% confidence interval of RDW and hs‐CRP were 0 .769 (95% CI:0 .683 -0 .842) ,0 .732 (95% CI:0 .656 -0 .820) .The optimal critical value of RDW and hs‐CRP were 14 .65% and 5 .92 mg/L ,the sensitivity and the the specificity were0 .769(95% CI:0 .683 -0 .842) and 0 .732(95%CI:0 .656-0 .820) respectively .The optimal critical values of RDW and hs‐CRP were hs‐CRP ,their sensitivity and specificity were 75 .8% ,61 .7% and 74 .5% ,62 .1% respectively .The multivariate Logistic regression analysis showed that RDW ,HDL ,smoking history and gender entered to the regression model ,the regression coefficients were 0 .624 ,7 .254 ,0 .630 and 0 .947 respectively .Conclusion RDW and hs‐CRP are associated with the severity of coronary artery lesions and CHD ,high level of RDW may be an independent risk factor of CHD .