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红细胞分布宽度(RDW)升高与非瓣膜性心房颤动有关。

Elevated levels of RDW is associated with non-valvular atrial fibrillation.

作者信息

Güngör Barış, Özcan Kazım Serhan, Erdinler İzzet, Ekmekçi Ahmet, Alper Ahmet Taha, Osmonov Damirbek, Çalık Nazmi, Akyuz Sukru, Toprak Ercan, Yılmaz Hale, Yıldırım Aydın, Bolca Osman

机构信息

Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Barbaros Mahallesi, Bekir Sıtkı Sezgin Sokak, Özlem Sitesi, B Blok, Daire: 9, 34087, Istanbul, Turkey.

出版信息

J Thromb Thrombolysis. 2014 May;37(4):404-10. doi: 10.1007/s11239-013-0957-1.

Abstract

Red cell distribution width (RDW) and neutrophil/lymphocyte ratio (NLR) have been found to be associated with cardiovascular diseases. Only a few trials have investigated the correlation of these parameters with postoperative atrial fibrillation (AF). However, the correlation of these parameters in non-valvular AF is still unclear. We retrospectively analyzed consecutive AF patients from medical records and included 117 non-valvular AF patients (103 paroxysmal and 14 chronic AF). All subjects underwent physical examination and echocardiographic imaging. Complete blood counts (CBCs) were analyzed for hemoglobin, RDW, neutrophil and lymphocyte counts as well as mean corpuscular volume. Results of CBC tests within the previous year were also included and the averages were used. The demographic and echocardiographic properties of non-valvular AF group were comparable to the control group except for left atrial volumes which were increased in AF (median 33.1, IQR 26.3-41.1 cm(3) vs. median 26.4, IQR 24.2-28.9 cm(3); p = 0.01). RDW levels were significantly higher in the AF group (median 13.4 %, IQR 12.9-14.1 %) compared to the control (median 12.6 %, IQR 12.0-13.1 %; p = 0.01). NLR was not statistically different in the AF group and the controls (2.04 ± 0.94 vs. 1.93 ± 0.64, respectively; p = 0.32). Hs-CRP levels were higher in the AF group compared to the controls (median 0.84, IQR 0.30-1.43 mg/L vs. median 0.29, IQR 0.18-0.50 mg/L, respectively; p = 0.01). Multivariate logistic regression analysis revealed RDW (OR 4.18, 95 % CI 2.15-8.15; p = 0.01), hs-CRP (OR 3.76, 95 % CI 1.43-9.89; p = 0.01) and left atrial volume (OR 1.31, 95 % CI 1.06-1.21; p = 0.01) as the independent markers of non-valvular AF. Multivariate linear regression analysis revealed that hemoglobin levels (standardized β coefficient = -0.252; p = 0.01) and the presence of AF (standardized β coefficient = 0.336; p = 0.01) were the independent correlates of RDW levels. Elevated RDW levels, not NLR, may be an independent risk marker for non-valvular AF.

摘要

红细胞分布宽度(RDW)和中性粒细胞/淋巴细胞比值(NLR)已被发现与心血管疾病有关。仅有少数试验研究了这些参数与术后心房颤动(AF)的相关性。然而,这些参数在非瓣膜性AF中的相关性仍不明确。我们回顾性分析了病历中连续的AF患者,纳入了117例非瓣膜性AF患者(103例阵发性和14例慢性AF)。所有受试者均接受了体格检查和超声心动图成像。分析全血细胞计数(CBC)中的血红蛋白、RDW、中性粒细胞和淋巴细胞计数以及平均红细胞体积。还纳入了前一年的CBC检测结果并计算平均值。非瓣膜性AF组的人口统计学和超声心动图特征与对照组相当,但AF组的左心房容积增加(中位数33.1,四分位数间距26.3 - 41.1 cm³ 对比中位数26.4,四分位数间距24.2 - 28.9 cm³;p = 0.01)。AF组的RDW水平显著高于对照组(中位数13.4%,四分位数间距12.9 - 14.1%),而对照组为(中位数12.6%,四分位数间距12.0 - 13.1%;p = 0.01)。AF组和对照组的NLR无统计学差异(分别为2.04 ± 0.94和1.93 ± 0.64;p = 0.32)。AF组的超敏C反应蛋白(Hs - CRP)水平高于对照组(分别为中位数0.84,四分位数间距0.30 - 1.43 mg/L对比中位数0.29,四分位数间距0.18 - 0.50 mg/L;p = 0.01)。多因素逻辑回归分析显示,RDW(比值比4.18,95%置信区间2.15 - 8.15;p = 0.01)、Hs - CRP(比值比3.76,95%置信区间1.43 - 9.89;p = 0.01)和左心房容积(比值比1.31,95%置信区间1.06 - 1.21;p = 0.01)是非瓣膜性AF的独立标志物。多因素线性回归分析显示,血红蛋白水平(标准化β系数 = -0.252;p = 0.01)和AF的存在(标准化β系数 = 0.336;p = 0.01)是RDW水平的独立相关因素。升高的RDW水平而非NLR可能是非瓣膜性AF的独立风险标志物。

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