2022 年第 9 期 第 17 卷

高龄急性心肌梗死患者入院时红细胞体积分布宽度与院内心脏不良事件的关系

The relationship between the red blood cell distribution width on admission and adverse cardiac events in elderly inpatients with acute myocardial infarction

作者：康云鹏郭雯李江刘文娴

英文作者：Kang Yunpeng Guo Wen Li Jiang Liu Wenxian

单位：首都医科大学附属北京安贞医院心内重症医学中心，北京100029

英文单位：Cardiac Intensive Care Unit Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：急性心肌梗死；红细胞体积分布宽度；院内心脏不良事件

英文关键词：Acutemyocardialinfarction；Redbloodcelldistributionwidth；Adversecardiaceventsinhospital

• 摘要：

• 目的 探讨高龄急性心肌梗死患者入院时红细胞体积分布宽度（RDW）与院内心脏不良事件的关系。方法  纳入2021年1月至2022年1月首都医科大学附属北京安贞医院心内重症医学中心收治的年龄≥75岁的急性心肌梗死患者132例。根据RDW的中位数将患者分为高RDW组（RDW＞13%，87例）和低RDW组（RDW≤13%，45例）。比较2组临床基线资料，入院后辅助检查指标和院内心脏不良事件发生情况，分析患者发生院内心脏不良事件的独立危险因素。结果  高RDW组患者年龄、吸烟比例均高于低RDW组［（79±4）岁比（77±2）岁、59.8%(52/87)比33.3%（15/45）］，差异均有统计学意义（均P＜0.05）。高RDW组入院检查中可见空腹血糖、血尿酸水平和舒张压高于低RDW组［（8.4±3.9）mmol/L比（6.9±2.5）mmol/L、（376±117）μmol/L比（325±104）μmol/L、（75±11）mmHg（1 mmHg=0.133 kPa）比（71±11）mmHg］，左心室射血分数低于低RDW组［（52±13）%比（59±13）%］，差异均有统计学意义（均P＜0.05）。高RDW组患者住院期间心源性休克、恶性心律失常发生率均高于低RDW组［9.2%(8/87)比4.4%(2/45)、12.6%(11/87)比6.7%(3/45)］，差异均有统计学意义(均P＜0.05)。Logistic回归分析结果显示，年龄、高RDW是导致急性心肌梗死患者发生院内心脏不良事件的独立危险因素（比值比=1.971，95%置信区间：1.262～2.881，P=0.015；比值比=1.224，95%置信区间：1.051～1.442，P=0.024）。结论 RDW是高龄急性心肌梗死患者发生院内心脏不良事件的独立危险因素。

• Objective  To investigate the relationship between red blood cell distribution width (RDW) on admission and adverse cardiac events in elderly inpatients with acute myocardial infarction. Methods  Totally 132 patients with acute myocardial infarction aged ≥ 75 years were enrolled, who were admitted to Cardiac Intensive Care Unit, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University from January 2021 to January 2022. According to the median of RDW, patients were divided into high RDW group (RDW＞13%, 87 cases) and low RDW group (RDW ≤ 13%, 45 cases). The clinical baseline data, assistant examination indexes after admission and the incidence of adverse cardiac events in hospital were compared between the two groups. The independent risk factors of adverse cardiac events in hospital were analyzed. Results  The age and smoking rate in high RDW group were significantly higher than those in low RDW group［（79±4）years vs （77±2）years, 59.8%(52/87) vs 33.3%（15/45）］ (both P＜0.05). The levels of fasting blood glucose, blood uric acid and diastolic blood pressure in the high RDW group were higher than those in the low RDW group［（8.4±3.9）mmol/L vs （6.9±2.5）mmol/L, （376±117）μmol/L vs （325±104）μmol/L, （75±11）mmHg vs （71±11）mmHg］, and left ventricular ejection fraction was lower than that in the low RDW group ［（52±13）% vs （59±13）%］(all P＜0.05). The incidences of cardiogenic shock and malignant arrhythmia in the high RDW group were higher than those in the low RDW group ［9.2%(8/87) vs 4.4%(2/45), 12.6%(11/87) vs 6.7%(3/45)］(both P＜0.05). Logistic regression analysis showed that age and high RDW were independent risk factors for adverse cardiac events in hospital(odds ratio=1.971，95% confidence interval：1.262-2.881，P=0.015； odds ratio=1.224， 95% confidence interval： 1.051-1.442， P=0.024). Conclusion  RDW is an independent risk factor for adverse cardiac events in elderly inpatients with acute myocardial infarction.