Objective: To investigate clinical implications of changes in red cell distribution width (RDW) and mean platelet volume (MPV) in patients with acute myocardial infarction.
Methods: A total of 127 patients (90 men and 37 women) were enrolled in this analysis, including 66 with acute myocardial infarction (AMI) and 61 with unstable angina (UA). The patients' baseline demographic and clinical data were compared between the two groups including age, hypertension, diabetes, smoking, BMI, blood biochemical profiles, cardiac functions and platelet and red blood cell parameters. The patients were further divided into subgroups according to the RDW 50% cumulative frequency, and the MPV, P-LCR, hsCRP, NT-proBNP, RBC, Dimer and MCV were compared. The correlations between platelet and erythrocyte test results were evaluated in both the AMI and UA patients. Regression analysis was performed to identify the factors affecting the RDW in the AMI group and a regression model was established.
Results: The platelet and red blood cell test results, P-LCR, MPV, and RDW differed significantly between AMI and UA groups (P<0.01 or 0.05). Correlation analysis showed a significant positive correlation between RDW and MPV in AMI group (r=0.34, P<0.01). Between the subgroups with different RDW 50% cumulative frequencies, MPV, P-LCR, hsCRP, D-Dimer, and NT-proBNP all differed significantly (P<0.05 or 0.01). In AMI group, with RDW as the dependent variable, we established a multivariate regression model of RDW=0.19MPV+10.83.
Conclusion: RDW and MPV are closely correlated in patients with AMI. In multiple regression analysis, MPV can explain the changes in RDW in patients with AMI.
目的: 研究急性心肌梗死患者红细胞分布宽度与平均血小板体积改变的临床意义。
方法: 入选诊断为急性心肌梗死（AMI）患者以及同期诊断为不稳定型心绞痛（UA）患者。共纳入127人, 男性90人, 女性37人。AMI组66例, UA组患者61人。比较两组临床基线资料, 血生化检测指标, 心功能, 血小板和红细胞指标的差异。以红细胞分布宽度（RDW）50%累积频率二次分组, 比较上述血生化和血细胞检测有意义指标的差异。分析AMI组和UA组中血小板与红细胞结果之间的相关性。建立AMI组中RDW为因变量的回归方程。
结果: 在AMI和UA组中, 大血小板比率, 平均血小板体积（MPV）差异有明显的统计学意义（P < 0.01）, RDW差异有明显的统计学意义（P < 0.05）。AMI组RDW与平均血小板体积相关分析有明显的统计学意义（r=0.34, P < 0.01）。RDW 50%累积频率分组中, MPV、大血小板比率、超敏C反应蛋白、D二聚体差异有明显的统计学意义（P < 0.05）, 氨基末端脑钠肽差异有明显的统计学意义（P < 0.01）。在AMI组中, 以RDW为因变量, MPV、大血小板比率、超敏C反应蛋白、D二聚体、氨基末端脑钠肽自变量进行多元回归分析, 回归方程RDW=0.19MPV+10.83。
结论: AMI组RDW与MPV具有明显的相关性, 在多元回归分析中, AMI组MPV可解释RDW改变。