原发性高血压患者红细胞分布宽度与Framingham心血管病风险等级的关系

发布时间：2018-04-01 22:21

本文选题：原发性高血压　切入点：红细胞分布宽度　出处：《中华高血压杂志》2017年01期

【摘要】：目的探讨原发性高血压患者红细胞分布宽度(RDW)与Framingham心血管病风险等级的关系。方法入选2014年9月至2016年8月在郑州大学第二附属医院心内科门诊及住院收治的原发性高血压患者383例,按Framingham心血管病风险等级将其分为低危组(n=176)、中危组(n=121)和高危组(n=86),另设正常血压对照组80例,检测所有患者血脂、肝肾功能、空腹血糖、RDW、高敏C反应蛋白(hsCRP)及左心室射血分数值,测量身高、体质量、血压,并计算体质量指数(BMI)。应用有序多分类Logistic回归分析RDW与Framingham心血管病风险等级的关系,采用受试者工作特征(ROC)曲线评价RDW对心血管病高危人群的判断价值。结果 4组年龄、BMI、吸烟、糖尿病、服用他汀类药物情况、收缩压、舒张压、低密度脂蛋白胆固醇(LDL-C)、胱抑素C、RDW、hsCRP等指标比较,差异有统计学意义(均P0.05)。4组RDW比较,高危组高于中危组[(13.42±0.92)%比(12.96±0.50)%],高危组、中危组高于低危组[(12.83±0.51)%]和对照组[(12.69±0.66)%](均P0.05)。Pearson相关分析显示RDW与LDL-C呈负相关(r=-0.105),与年龄、胱抑素C、hsCRP、Framingham心血管病风险等级呈正相关(分别r=0.182、0.151、0.566、0.312,均P0.05)。有序多分类Logistic回归分析结果显示,在校正了年龄、BMI、吸烟、糖尿病、服用他汀类药物情况、收缩压、舒张压、LDL-C、胱抑素C、hsCRP后,RDW仍是Framingham心血管病风险等级的独立危险因素(OR=5.601,95%CI1.557~20.146)。ROC曲线分析示RDW12.95%是预测心血管病高危人群的最佳截断点,其灵敏度为75.6%,特异度为63.9%,ROC曲线下面积为0.735(95%CI0.676~0.793,P0.001)。结论原发性高血压患者RDW升高,原发性高血压患者RDW可能与Framingham心血管病风险等级相关。
[Abstract]:Objective to investigate the relationship between erythrocyte distribution width (RDW) and Framingham cardiovascular risk grade in patients with essential hypertension. Methods the patients were selected from September 2014 to August 2016 in the outpatient and inpatient department of cardiology, second affiliated Hospital of Zhengzhou University. 383 patients with hypertension, The patients were divided into low risk group (n = 176), middle risk group (n = 121) and high risk group (n = 80) according to the risk grade of Framingham cardiovascular disease. Blood lipids, liver and kidney function, fasting blood glucose (FBG), Gao Min C-reactive protein (hsCRP) and left ventricular ejection fraction (LVEF) were measured in all patients. Height, body mass, blood pressure were measured, and body mass index (BMI) was calculated. The relationship between RDW and Framingham cardiovascular risk grade was analyzed by using ordered multiple classification Logistic regression analysis. Results RDW, smoking, diabetes, statins, systolic blood pressure, diastolic blood pressure were used to evaluate the value of RDW in high risk groups of cardiovascular diseases. There was a significant difference in LDL-CU and RDW-hsCRP between the high risk group and the middle risk group (all P0.054.The RDW was higher in the high risk group than in the middle risk group [13.42 卤0.92% vs 12.96 卤0.50%], and the difference was significant between the high risk group and the high risk group. The risk of cardiovascular disease in moderate risk group was higher than that in low risk group [12.83 卤0.51%] and control group (12.69 卤0.66%). (all P0.05).Pearson correlation analysis showed that RDW and LDL-C were negatively correlated with LDL-C, and positively correlated with age, cystatin, cystatin, cystatin, CRP, CRP, risk grade (r 0.182 0. 151%, P 0. 05%, P 0. 05). The results of Logistic regression analysis showed that there was no significant difference between the two groups (r 0. 182 0. 1 0. 151 0. 56 6%, P 0. 05). After adjusting the age of BMI, smoking, diabetes, taking statins, systolic blood pressure, RDW is still the independent risk factor of cardiovascular disease risk grade of Framingham. The curve analysis shows that RDW 12.95% is the best cutoff point for predicting cardiovascular disease risk group, and the ROC curve analysis shows that RDW 12.95% is the best cutoff point for predicting cardiovascular disease risk group, and ROC curve analysis shows that RDW 12.95% is the best cutoff point for predicting cardiovascular disease risk group, and ROC curve analysis shows that RDW 12.95% is the best cutoff point for predicting cardiovascular risk population. The sensitivity was 75.6, the specificity was 63.9 and the area under the ROC curve was 0.73595. Conclusion RDW in patients with essential hypertension is increased and RDW may be associated with the risk of Framingham cardiovascular disease.
【作者单位】：郑州大学第二附属医院心内科;河南省人民医院心功能科;
【分类号】：R544.11

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