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目的探讨红细胞形态学参数与急性心肌梗死(AMI)患者的相关性,以及对短期预后的评估价值。方法选取2016年5-8月急诊胸痛中心收治的胸痛、胸闷患者103例,诊治第一时间测定患者血常规,包括红细胞平均血红蛋白浓度(MCHC)、红细胞平均血红蛋白量(MCH)、红细胞平均体积(MCV)和红细胞分布宽度(RDW),依据急诊诊断分为AMI组(n=35)和非AMI组(n=68);通过电话随访记录患者30 d内的主要不良心血管事件(MACE)。运用描述性统计学方法分别分析两组患者红细胞形态学参数水平变化及与30 d内主要不良心血管事件发生的相关性。结果 AMI组RDW水平明显高于非AMI组[(0.141±0.014)vs.(0.133±0.010)],差异有统计学意义(P<0.05);AMI组30 d内MACE发生率显著高于非AMI组(20.00%vs.4.94%),差异有统计学意义(P<0.05);AMI组30 d内发生MACE患者RDW水平显著高于同组30 d内未发生MACE患者[(0.154±0.222)vs.(0.137±0.009)],差异有统计学意义(P<0.05);其他红细胞形态学参数(MACH,MCH,MCV)在两组水平,以及预测30 d MACE发生方面差异无统计学意义(P>0.05)。结论 RDW与AMI发生显著相关,能预测患者30 d内主要不良心血管事件的风险。
Objective To investigate the correlation between erythrocyte morphological parameters and acute myocardial infarction (AMI) and to assess the short-term prognosis. Methods Totally 103 patients with chest pain and chest tightness admitted during the May-August 2016 emergency chest pain center were enrolled in this study. The blood routine, including the average hemoglobin concentration (MCHC), the average hemoglobin (MCH), the average volume of erythrocytes MCV and RDW were divided into AMI group (n = 35) and non-AMI group (n = 68) according to emergency diagnosis. Major adverse cardiovascular events (MACE) within 30 days were recorded by telephone follow-up. Descriptive statistics were used to analyze the changes of erythrocyte morphological parameters and the association with major adverse cardiovascular events within 30 days in both groups. Results The RDW level in AMI group was significantly higher than that in non-AMI group [(0.141 ± 0.014) vs. (0.133 ± 0.010)], the difference was statistically significant (P <0.05) (20.00% vs.4.94%), the difference was statistically significant (P <0.05). The RDW level in MACE patients within 30 days in AMI group was significantly higher than that in MACE patients within 30 days [(0.154 ± 0.222) vs (0.137 ± 0.009)], the difference was statistically significant (P <0.05). The other erythrocyte morphology parameters (MACH, MCH and MCV) had no significant difference between the two groups in the prediction of 30-day MACE occurrence > 0.05). Conclusions RDW is significantly associated with AMI and can predict the risk of major adverse cardiovascular events within 30 days.