摘要
目的：探讨红细胞分布宽度（RDW）在急性肺血栓栓塞症（APE）思者长期随访中的作用。方法：筛选2009-01至2012—12在阜外医院心内科肺血管病房住院的首次APE患者214例，根据RDW是否增高分为RDW≤15％组（n=202）和RDW〉15％组（n=12）。测定基础的RDW值，并在APE后第3、6、12个月随访，此后每年随访1次，主要终点事件为慢性血栓栓塞性肺动脉高压（CTEPH）。用单变量和多变量Logistic回归分析确定CTEPH的独立预测因子，受试者工作特征（ROC）曲线评价RDW的预测能力。结果：全部患者完成随访，平均随访时间（31±17）个月，CTEPH的发生率是7．5％（16／214）。RDW〉15％组CTEPH发生率明显高于RDW≤15％组（33．3％vs5．9％，P=0．002）。多变量Logistic回归分析：在校正临床资料和其他预测因素后，RDW〉15％仍是强有力的发生CTEPH独立预测因子（比值比=7．916，95％可信区间：1．474～42．500，P=0．016）。在预测模型中增加RDW能显著增加模型的预测能力（ROC曲线下面积从0．856增加至0．901，P〈0．01）。结论：RDW增高是APE后发生CTEPH的独立预测因子，有助于判断APE患者的转归及决定治疗策略。
Objective：To explore the effect of red blood cell distribution width （RDW） on long-term follow-up study in patients with acute pulmonary thromboembolism （APE）. Methods： A total of 214 consecutive patients with the first episode of APE admitted in our hospital from 2009-01 to 2012-12 were enrolled. The patients were divided into 2 groups： RDW〈15% group, n=202 and RDW〉15% group, n=12. Baseline RDW was measured at admission, the follow-up study was conducted at 3, 6, 12 months thereafter, and then at once per year. The major primary end point was chronic thromboembolic pulmonary hypertension （CTEPH）. The independent predictor for CTEPH occurrence was studied by uni- and multivariate logistic regression analysis and the predictive capability of RDWwas evaluated by ROC curve. Results： All patients finished the follow-up study at the mean of （31 ±17） months. The overall occurrence rate of CTEPH was 7.5% （16/214）, which was higher in RDW〉15% group than that in RDW〈15% group （33.3% vs 5.9%, P=0.002）. Multivariate logistic regression analysis indicated that with adjusted clinical data and other predictors, RDW〉15% was still the strong predictor for CTEPH occurrence （OR=7.916, 95% CI 1.474-42.500, P=0.016）. Adding RDW to the evaluating model, the predictive capability could be significantly improved by ROC curve （AUC increased from 0.856 to 0.901, P〈 0.01）. Conclusion： Elevated RDW is the independent predictor for CTEPH occurrence in APE patients, which is helpful to estimate the prognosis and treatment strategy in APE patients.
出处
《中国循环杂志》
CSCD
北大核心
2016年第1期65-68,共4页
Chinese Circulation Journal
基金
国家"十一五"科技支撑计划项目(2006BAIOIA06)
关键词
肺血栓
高血压
肺性
红细胞分布宽度
Pulmonary embolism
Hypertension, pulmonary
Red blood cell distribution width
