Vayá Amparo, Rivera Leonor, de la Espriella Rafael, Sanchez Fernando, Suescun Marta, Hernandez José Luis, Fácila Lorenzo
Haemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain.
Cardiology Service. General Hospital Valencia, Valencia, Spain.
Clin Hemorheol Microcirc. 2015;59(2):107-14. doi: 10.3233/CH-131751.
Increased RDW has been found to be a marker of adverse outcomes in cardiovascular disease (CVD), although the exact mechanism remains unclear. Recently, several authors have found that higher RDW is associated with decreased erythrocyte deformability, which can impair blood flow through microcirculation, a fact which may explain the increased risk for CVD events associated with elevated RDW. The aim of the present study was to investigate the association between RDW and erythrocyte deformability in patients with acute myocardial infarction (AMI). The study group comprised 60 AMI patients and 72 gender- and age-matched controls, in whom erythrocyte deformability was determined by means of the elongation index (EI) in a Rheodyn SSD, along with haematological, biochemical and inflammatory parameters. Patients showed higher RDW (p = 0.012) and lower EI (p < 0.05) than controls. When anaemic patients were removed from the study, AMI showed still lower EI than controls (p < 0.05), but no differences in RDW were observed (p = 0.141). RDW correlated inversely with haematimetric indices (p < 0.001), but not with inflammatory and biochemical parameters (p > 0.05). EI correlated inversely with Hb, MCHC (p < 0.001) and directly with MCV (p < 0.05). EI also correlated inversely with glucose (p < 0.05) and directly with HDL-cholesterol (p < 0.05). The multivariate regression model showed that only MCV and Hb were independent predictors of RDW (beta coefficients: -0.383, -0.208; p < 0.001, p = 0.050, respectively). In addition, MCV, MCHC and hyperlipidaemia were independent predictors of EI (beta coefficients: 0.366, -0.533, -0.192; p < 0.001, p < 0.001, p = 0.019 respectively). In AMI patients, increased RDW is not related with EI, so this mechanism does not seem to be responsible for an increased CDV risk in these patients.
红细胞分布宽度（RDW）升高已被发现是心血管疾病（CVD）不良预后的一个标志物，尽管确切机制尚不清楚。最近，几位作者发现较高的RDW与红细胞变形性降低有关，这会损害微循环中的血流，这一事实可能解释了与RDW升高相关的CVD事件风险增加的原因。本研究的目的是调查急性心肌梗死（AMI）患者中RDW与红细胞变形性之间的关联。研究组包括60例AMI患者和72例性别和年龄匹配的对照组，通过Rheodyn SSD中的伸长指数（EI）以及血液学、生化和炎症参数来测定红细胞变形性。患者的RDW高于对照组（p = 0.012），EI低于对照组（p < 0.05）。当将贫血患者排除在研究之外时，AMI患者的EI仍低于对照组（p < 0.05），但RDW未观察到差异（p = 0.141）。RDW与血液学指标呈负相关（p < 0.001），但与炎症和生化参数无关（p > 0.05）。EI与血红蛋白（Hb）、平均血红蛋白浓度（MCHC）呈负相关（p < 0.001），与平均红细胞体积（MCV）呈正相关（p < 0.05）。EI还与血糖呈负相关（p < 0.05），与高密度脂蛋白胆固醇呈正相关（p < 0.05）。多变量回归模型显示，只有MCV和Hb是RDW的独立预测因子（β系数分别为：-0.383，-0.208；p < 0.001，p = 0.050）。此外，MCV、MCHC和高脂血症是EI的独立预测因子（β系数分别为：0.366，-0.533，-0.192；p < 0.001，p < 0.001，p = 0.019）。在AMI患者中，RDW升高与EI无关，因此这种机制似乎不是这些患者CVD风险增加的原因。
