红细胞比容与老年冠心病患者冠状动脉病变的相关性研究

摘要

目的 探讨红细胞比容与老年冠心病患者冠状动脉病变的相关性.方法 选择行冠状动脉造影检查的老年患者598例,根据冠状动脉造影结果分为冠心病组422例和非冠心病组176例.比较2组一般临床资料、血常规、血生化等多项指标的差异,计算冠状动脉病变的SYNTAX评分.结果 冠心痛组年龄、男性、吸烟、糖尿病、红细胞沉降率、白细胞计数、中性粒细胞、单核细胞、空腹血糖、TG、LDL-C、脂蛋白(a)明显高于非冠心病组,红细胞计数、血红蛋白、红细胞比容、HDL-C明显低于非冠心痛组,差异有统计学意义(P＜0.05,P＜0.01).Spearman秩相关分析显示,红细胞比容与SYNTAX评分呈负相关(r=-0.151,P=0.000).红细胞比容对冠心病发生的ROC曲线下面积为0.589(95 ％CI:0.540～0.639,P=0.001).其中红细胞比容截断点为39.95％,敏感性为61.1％,特异性为46.6％.结论 红细胞比容与老年冠心痛患者冠状动脉病变严重程度密切相关,红细胞比容降低在一定程度上可以预测冠心痛发生的风险.%Objective To study the relationship between hematocrit and coronary artery lesions in elderly coronary heart disease (CHD) patients.Methods Five hundred and ninety-eight elderly patients were divided into CHD group (n=422) and CHD-free group (n=176) according to their coronary angiography.Their general clinical data,routine blood test parameters and biochemical test parameters were compared.The SYNTAX score of coronary artery lesions was recorded.Results The age was significantly older,the ratio of males and smoking was significantly higher,the incidence of DM and the ESR were significantly higher,the number of WBC,neutrophils and monocytes was significantly greater,the serum levels of FBG,TG,LDL-C and apolipoprotein A were significantly higher whereas the number of RBC was significantly smaller,the serum hemoglobin and LDL-C levels and hematocrit were significantly lower in CHD group than in CHD-free group (P＜0.05,P＜0.01).Spearman rank correlation analysis showed that the hematocrit was negatively related with the SYNTAX score (r=-0.151,P=0.000).The area under the ROC curve for hematocrit in predicting CHD was 0.589 (95％CI:0.540-0.639,P=0.001).The cut-off point value of hematocrit was 39.95％ with a sensitivity of 61.1％ and a specificity of 46.6％.Conclusion Hematocrit is closely related with coronary artery lesions in elderly CHD patients,and lower hematocrit can predict the risk of CHD.