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目的探讨急性冠脉综合征(cute coronary syndrome,ACS)患者红细胞分布宽度(red blood cell distribution width,RDW)-SD与全球急性冠状动脉事件注册(global registry of acute coronary events,GRACE)评分之间的关系。分析RDW-SD水平对ACS患者住院期间发生主要不良心脏事件(major adverse cardiac events,MACE)的预测价值。方法回顾分析2015年6月至2016年8月,首都医科大学附属北京天坛医院心脏重症监护病房104例ACS患者,根据GRACE评分,将ACS患者分为低危组(GRACE评分≤108分)、中危组(GRACE评分109-140分)和高危组(GRACE评分>140分)3组,分别检测各亚组ACS患者RDW-SD。将RDW-SD水平从低到高按四分位数分成Ql~4组,各组GRACE评分及高危百分比。分析RDW-SD与GRACE评分的相关性。使用受试者工作曲线分析基线RDW-SD水平及GRACE评分对ACS患者住院期间发生MACE的曲线下面积,评估其预测价值。结果在ACS患者3个亚组中,高危组患者RDW-SD结果高于中危组(P<0.05)和低危组(P<0.01),中危组RDW-SD高于低危组(P<0.01),差异有统计学意义。Q4组GRACE评分及高危百分比高于Q4以下组(P<0.05)。相关性分析显示,RDW-SD结果与GRACE评分呈正相关(r=0.473,P<0.01)。基线RDW-SD水平及GRACE评分对ACS患者住院期间发生MACE的曲线下工作面积分别为0.663和0.762,两者比较差别有统计学意义(P<0.05)。结论RDW-SD水平的检测和GRACE评分对ACS患者住院期间发生MACE的预测有较好价值,它可能成为ACS患者预后判断的重要指标。
Objective To investigate the relationship between red blood cell distribution width (RDW) -SD and global registry of acute coronary events (GRACE) scores in patients with acute coronary syndrome (ACS) relationship. The predictive value of RDW-SD levels for major adverse cardiac events (MACE) during hospitalization in patients with ACS was analyzed. Methods From June 2015 to August 2016, 104 patients with ACS in Beijing Tiantan Hospital ICU from Capital University of Medical Sciences were divided into low risk group (GRACE score ≤108) according to GRACE score, Risk group (GRACE score 109-140) and high risk group (GRACE score> 140) three groups were detected in each subgroup of ACS patients with RDW-SD. The RDW-SD levels were divided into Ql ~ 4 quartiles from low to high, and the GRACE scores and high-risk percentage in each group. Analysis of RDW-SD and GRACE score relevance. The subjects’ working curves were used to analyze the baseline RDW-SD levels and the GRACE score to assess the predictive value of the area under the curve of MACEs occurring during hospitalization in patients with ACS. Results Among the 3 subgroups of ACS patients, the RDW-SD results of high-risk group were higher than that of moderate-risk group (P <0.05) and low-risk group (P <0.01) <0.01), the difference was statistically significant. The GRACE scores and high-risk percentage in Q4 group were higher than those in Q4 group (P <0.05). Correlation analysis showed that RDW-SD was positively correlated with GRACE (r = 0.473, P <0.01). Baseline RDW-SD levels and GRACE scores were 0.663 and 0.762 for the MACE incidence of MACE during hospitalization, respectively, with a statistically significant difference (P <0.05). Conclusion The detection of RDW-SD and the GRACE score have a good value in predicting the occurrence of MACE during hospitalization in patients with ACS, which may be an important indicator of prognosis in patients with ACS.