王军,华琦,王丽,王云飞,李小明,薛淞,范振兴,李博宇,胡少东,刘马超,李静

• 1:北京市门头沟区医院心内科
• 2:首都医科大学宣武医院心内科
• 3:清华大学第一附属医院华信医院心内科

摘要(Abstract)：

目的评价红细胞分布宽度(red blood cell distribution width,RDW)对置入药物洗脱支架(drug eluting stent,DES)的急性ST段抬高心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者预后的影响。方法连续入选急性STEMI患者484例,根据RDW值分为4组:A组(RDW<12.30%)、B组(12.30%≤RDW<12.90%)、C组(12.90%≤RDW<13.51%)和D组(RDW≥13.51%)。对4组患者临床资料、住院期间心血管事件以及长期预后随访进行比较。结果4组患者RDW、高血压、糖尿病、血糖、左心室射血分数(LVEF)、LVEF<40%、B型病变、C型病变比较,差异有统计学意义(P<0.05);住院期间死亡和主要不良心脑血管事件(main adverse cardiovascular and cerebrovascular events,MACCE)比较,差异有统计学意义(P=0.027和P=0.021),随访结果显示,4组患者全因死亡、心原性死亡、MACCE和支架内血栓发生率比较,差异有统计学意义(P=0.006、P=0.012、P=0.002和P=0.036);Cox回归分析显示,RDW显著提高全因死亡(HR1.577,95%CI 1.196~2.079,P=0.001)和MACCE(HR 1.456,95%CI 1.154~1.838,P=0.002)的发生率。D组的MACCE发生率高于其他3组(P<0.05)。结论对于置入DES的急性STEMI的非贫血患者,RDW升高是一个预测死亡和MACCE的独立危险因素。

关键词(KeyWords)： 急性心肌梗死;经皮冠状动脉介入治疗;药物洗脱支架;红细胞分布宽度

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81470491)

作者(Author): 王军,华琦,王丽,王云飞,李小明,薛淞,范振兴,李博宇,胡少东,刘马超,李静

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