RDW对STEMI患者急诊PCI术后长期预后的预测价值

发布时间：2018-05-03 15:38

  本文选题：ST段抬高型心肌梗死 + 红细胞分布宽度　； 参考：《新疆医科大学》2016年硕士论文

【摘要】：目的:研究红细胞分布宽度(RDW)对急性ST段抬高性心肌梗死患者行急诊PCI术后的长期预后的预测价值。方法:连续前瞻性选取我院2011年09月至2014年11月的急性ST段抬高性心肌梗死(STEMI)急诊行PCI术的住院患者共309例患者作为研究对象。依据RDW正常范围上限(14%),将患者分为高RDW组和低RDW组患者。选取死亡作为主要研究终点事件,心血管不良事件(MACE)作为次要研究指标。采用Kaplan-Meier生存分析判断高低RDW组患者累计生存率的差异,采用多元Cox回归分析研究STEMI患者PCI术后死亡的独立影响因素。结果:309例STEMI患者纳入本研究,最长随访时间40月,中位随访时间10(3-24)月。高RDW组患者住院期间死亡率高于低RDW组患者(P=0.018),高RDW组患者出院后随访期间的MACE(P=0.003)和死亡事件(P=0.029)均高于低RDW组患者,且具有统计学差异,但两组患者再发心梗、靶血管重建和脑卒中事件无统计学差异。多因素Cox回归分析显示,年龄(HR:1.06,95%CI:1.02-1.08,P=0.004),白细胞(HR:1.16,95%CI:1.07-1.25,P0.001),高RDW(HR:2.21,95%CI:1.23-4.67,P=0.023),肌酐(HR:1.007,95%CI:1.003-1.011,P=0.001)和左室射血分数(HR:0.93,95%CI:0.89-0.98,P=0.002)为STEMI患者死亡的独立影响因素。Kaplan-Meier生存分析显示,高RDW组患者累计生存率明显低于低RDW组患者,且具有统计学差异(Log Rank=8.00,P=0.005)。高RDW组患者累计死亡率为19.5%,低RDW组患者累计死亡率为8.1%,且差异具有统计学意义(χ2=8.80,P=0.003)。结论:高RDW是STEMI患者行急诊PCI术后长期死亡的独立危险因素,可用于患者入院后危险分层。
[Abstract]:Objective: to study the prognostic value of RDW in patients with acute ST-segment elevation myocardial infarction after emergency PCI. Methods: a total of 309 patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing emergent PCI operation in our hospital from September 2011 to November 2014 were selected as subjects. According to the upper limit of RDW, the patients were divided into high RDW group and low RDW group. Death and adverse cardiovascular events were selected as the main endpoint events and MACEE as the secondary criteria. Kaplan-Meier survival analysis was used to judge the difference of cumulative survival rate in patients with high and low RDW. Multiple Cox regression analysis was used to study the independent factors influencing the death after PCI in STEMI patients. Results in this study, 309 STEMI patients were included in the study. The longest follow-up period was 40 months, and the median follow-up time was 103 to 24 months. The in-hospital mortality rate of high RDW group was higher than that of low RDW group, and that of high RDW group was higher than that of low RDW group (P 0.029), and the mortality of high RDW group was higher than that of low RDW group. However, there was a significant difference between the two groups in recurrent myocardial infarction. There was no significant difference in target vascular remodeling and stroke events. 澶氬洜绱燙ox鍥炲綊鍒嗘瀽鏄剧ず,骞撮緞(HR:1.06,95%CI:1.02-1.08,P=0.004),鐧界粏鑳，

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