红细胞体积分布宽度对STEMI患者术后心肌灌注水平及近期预后的预测价值

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Abstract Objective To study the predictive value of RBC volume distribution width (RDW) on post-operative myocardial perfusion level and short-term prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Methods One hundred and thirty-eight patients with first-episode acute STEMI who were enrolled in Chengdu Third People′s Hospital from January 2017 to January 2018 were selected for the study. The patients were divided into observation group (no reflow, no complete ST segment resolution after operation, 47 cases) and control group (normal reflow, complete ST segment resolution after operation, 91 cases). The clinical indexes of two groups were detected and compared, the predictive effect of RDW and high sensitivity C-reactive protein (hs-CRP) on no reflow after percutaneous coronary intervention (PCI) was analyzed; RDW=14.48% was taken as the best cut-off point, the patients with first-episode acute STEMI was divided into the RDW≥14.48% group (52 cases) and the RDW<14.48% group (86 cases), and the incidence of no reflow, adverse cardiovascular events (MACEs) and survival prognosis between two groups were compared. Results The levels of RDW and hs-CRP in observation group were significantly higher than those in control group, and the ratio of infarct related artery to TIMI blood flow grade 3 after PCI in observation group was significantly lower than that in control group (all P < 0.05). ROC curve analysis showed that RDW was better than hs-CRP in the prediction of no reflow after PCI. When the area under the curve was 0.794 and RDW was 14.48%, the prediction value was the highest. The incidence of no reflow and MACEs in RDW≥14.48% group was significantly higher than that in RDW<14.48% group (all P < 0.05). The incidence of no reflow and MACEs in RDW≥14.48% group was significantly higher than that in RDW<14.48% group (all P < 0.05). There was no significant difference between two groups in survival and prognosis (P > 0.05). Conclusion RDW has a high predictive value for myocardial perfusion level and MACEs in patients with STEMI. Early monitoring of RDW level can be used to evaluate and judge the prognosis of STEMI patients. Ultimately, it helps to choose more scientific treatment options.

Key words： RBC volume distribution width ST-segment elevation myocardial infarction Post-operative myocardial perfusion Prognosis

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	LI Ke1 WANG Yan2 WU Jing3 WANG Xiaoqi1 ZHANG Zhen3

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LI Ke1 WANG Yan2 WU Jing3 WANG Xiaoqi1 ZHANG Zhen3. Predictive value of RBC volume distribution width on myocardial perfusion level and short-term prognosis in patients with STEMI[J]. 中国医药导报, 2020, 17(2): 89-92,100.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I2/89

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