红细胞分布宽度、血清总胆红素与冠心病及冠状动脉病变程度相关性研究

doi:10.3969/j.issn.1673-8640.2019.10.005

摘要/Abstract

摘要： 目的探讨红细胞分布宽度（RDW）和血清总胆红素（TB）与冠心病（CHD）及冠状动脉病变支数和Gensini积分之间的关系。方法选取200例行诊断性冠状动脉造影的CHD患者（CHD组）,以冠状动脉造影结果阳性（主要血管直径狭窄≥50%）作为诊断CHD的标准。另选取体检健康者100名为正常对照组。检测所有对象的RDW和TB。采用Pearson线性相关分析评估RDW和TB与总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、心肌肌钙蛋白I（cTnI）、肌红蛋白（MYO）、B型钠尿肽（BNP）和肌酸激酶MB同工酶（CK-MB）的相关性;比较不同冠状动脉病变支数患者RDW和TB的差异。采用Spearman相关分析评估RDW和TB与Gensini积分的相关性。结果与正常对照组比较,CHD组RDW明显升高（P<0.05）,TB水平明显降低（P<0.05）。CHD组RDW与HDL-C呈负相关（r=-0.677,P<0.05）,与cTnI呈正相关（r=0.196,P<0.01）;TB与HDL-C呈正相关（r=0.525,P<0.05）,与cTnI呈负相关（（r=-0.118,P<0.05）。冠状动脉1支、2支和3支病变患者RDW依次显著升高（P<0.01）,TB依次显著降低（P<0.01）。RDW与Gensini积分呈正相关（r=0.437,P<0.05）,TB与Gensini积分呈负相关（r=-0.385,P<0.05）。结论 RDW、TB与CHD患者冠状动脉病变严重程度相关,在CHD风险和预后评估中有一定价值。

关键词: 红细胞分布宽度, 总胆红素, 冠心病, 冠状动脉病变, Gensini积分

Abstract: Objective To investigate the relations of red blood cell distribution width（RDW） and serum total bilirubin（TB） with coronary heart disease（CHD） and its coronary artery lesion branches and Gensini score. Methods A total of 200 CHD patients undergoing coronary angiography were enrolled as CHD group,taking positive coronary angiography（stenosis of major vessels ≥ 50%） as diagnostic standard of CHD. Totally,100 healthy subjects were enrolled as control group. The levels of RDW and TB were determined,and the relations of total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,cardiac troponin I（cTnI）,myoglobin（MYO）,B-type natriuretic peptide（BNP）and creatinine kinase-MB isoenzyme（CK-MB）with RDW and TB were analyzed by. Statistical analysis was used to analyze the difference between RDW and TB in patients with different coronary artery lesion branches. Spearman correlation analysis was used to analyze the relation between the levels of RDW and TB and Gensini score. Results RDW was higher in CHD group than that in control group（P<0.05）,and the level of TB was decreased（P<0.05）. In CHD group,RDW was negatively correlated with HDL-C（r=-0.677,P<0.05） and positively correlated with cTnI（r=0.196,P<0.01）,and TB was positively correlated with HDL-C（r=0.525,P<0.05）and negatively correlated with cTnI（r=-0.118,P<0.05）. RDW in patients with single-,double- and triple-branch coronary artery lesions increased in turn（P<0.01）,and TB decreased in turn（P<0.01）. RDW level was positively correlated with Gensini score（r=0.437,P<0.05）. TB level was negatively correlated with Gensini score （r=-0.385,P<0.05）. Conclusions RDW and TB are correlated with CHD and the severity of coronary artery lesions,and they play roles in the evaluation of CHD risk and prognosis.

Key words: Red blood cell distribution width, Total bilirubin, Coronary heart disease, Coronary artery lesion, Gensini score

中图分类号:

R446.1

丁宁, 陈长强, 樊绮诗. 红细胞分布宽度、血清总胆红素与冠心病及冠状动脉病变程度相关性研究[J]. 检验医学, 2019, 34(10): 889-893.

DING Ning, CHEN Changqiang, FAN Qishi. Correlations of RDW and TB with coronary heart disease and the extent of coronary atherosclerosis[J]. Laboratory Medicine, 2019, 34(10): 889-893.

图/表 6

参考文献 16

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组别	RDW（%）	TB（µmol/L）
正常对照组	13.34±0.60	16.30±2.05
CHD组	13.88±2.00	12.41±4.73
t值	6.75	25.39
P值	0.010	0.000

组别	RDW（%）	TB（µmol/L）
正常对照组	13.34±0.60	16.30±2.05
CHD组	13.88±2.00	12.41±4.73
t值	6.75	25.39
P值	0.010	0.000

项目	LDL-C	HDL-C	TC	TG	CK-MB	cTnI	BNP	MYO	收缩压	舒张压
RDW
r值	0.022	-0.677	0.043	-0.037	0.114	0.196	0.251	0.195	0.058	-0.080
P值	>0.05	<0.05	>0.05	>0.05	>0.05	<0.01	>0.05	>0.05	>0.05	>0.05
TB
r值	-0.037	0.525	0.138	-0.071	0.063	-0.118	-0.096	0.146	-0.114	0.140
P值	>0.05	<0.05	>0.05	>0.05	>0.05	<0.05	>0.05	>0.05	>0.05	>0.05

项目	LDL-C	HDL-C	TC	TG	CK-MB	cTnI	BNP	MYO	收缩压	舒张压
RDW
r值	0.022	-0.677	0.043	-0.037	0.114	0.196	0.251	0.195	0.058	-0.080
P值	>0.05	<0.05	>0.05	>0.05	>0.05	<0.01	>0.05	>0.05	>0.05	>0.05
TB
r值	-0.037	0.525	0.138	-0.071	0.063	-0.118	-0.096	0.146	-0.114	0.140
P值	>0.05	<0.05	>0.05	>0.05	>0.05	<0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	RDW（%）	TB（µmol/L）
1支病变组	104	13.37±0.68	13.29±3.98
2支病变组	50	14.28±2.61^*	12.36±5.58^*
3支病变组	46	14.58±1.56^**#	10.04±3.06^**#