Correlation Analysis Of Red Blood Cell Distribution Width, Vascular Endothelial Function And Blood Stasis Syndrome In Patients With Coronary Heart Disease

This article includes two parts:literature review and clinical research.First.Literature ReviewLiterature review mainly discussed the distribution width of erythrocyte volume as a new predictor of cardiovascular disease,which is closely related to all-cause mortality,cardiovascular disease mortality,incidence of coronary heart disease,risk of myocardial infarction,severity of coronary artery disease,complexity of lesions,hypertension,arrhythmia,heart failure and so on.Emphasis was placed on the interrelation of RDW and vascular endothelial function.The possible mechanism of RDW rising is discussed.The relationship between RDW and blood stasis syndrome of coronary heart disease was discussed from the viewpoint of traditional medicine’s understanding of the etiology and pathogenesis of coronary heart disease and the essence of blood stasis syndrome of modern medicine.Second.Clin ical ResearchObjective:To analyze the relationship between RDW and severity of coronary heart disease and coronary artery disease,vascular endothelial function by detecting FMD of brachial artery and RDW in blood samples,calculating Gensini integral and blood stasis syndrome integral,and to explore the relationship between RDW and blood stasis syndrome of coronary heart disease,so as to provide laboratory evidence for TCM dialectics of blood stasis syndrome.Methods:This study used cross-sectional survey method,according to the exclusion criteria,and took the patients hospitalized in the Department of Cardiology of Chinese and Japanese Friendship Hospital and Western Medicine from April 2018 to March 2019 as the research objects.All the subjects were examined by coronary angiography.250 patients who met the diagnostic criteria of coronary heart disease were collected as the case group,and 50 patients with normal coronary angiography were selected as the control group.The patients were divided into stable angina pectoris group,unstable angina pectoris group and acute myocardial infarction group.General data,laboratory indicators,FMD values of patients were collected,and Gensini score and blood stasis syndrome score were calculated according to the results of coronary angiography,SPSS20.0 statistical software was used for data analysis.The measurement data between the two groups were tested by t-test and non-parametric test of two independent samples;the counting data between the two groups were tested by chi-square test;the data of multiple groups were analyzed by one-way ANOVA and non-parametric test;and the correlation analysis was conducted by Spearman analysis.The difference was significant with P<0.05.Results:1.The clinical data of the four groups were tested by₂ test,one-way ANOVA or independent sample nonparametric test.The results showed that there were significant differences in smoking history,hypertension,age,CRP,CHO,LDL-C,HDL-C,CR,GLU,HbAlc,RDW-CV,WBC,HCY and Fib levels among the four groups.There were no significant differences in gender,weight,BMI,drinking history,diabetes mellitus,HGB,TG,UA and Urea levels.2.In this study,RDW was divided into four groups:1 group（11<RDW<12）,2 groups（12<RDW<13）,3 groups（13<RDW<14）,and 4 groups（RDW>14）.One-way ANOVA or multiple independent sample rank sum tests were used.The results showed that the distribution of HGB,FMD,Gensini integral,LP（a）and Urea in different RDW groups had statistical difference,while CR,CHO,LDL-C,Apo-A1,Apo-B,Apo-E,Apo-C2,Apo-C3,HCY,HDL-C,UA,TG,Fib,HbAlc,HS-CRP had no statistical difference among RDW groups.3.According to the results of coronary angiography,the number of lesion vessels was calculated and divided into single-vessel lesion group,double-vessel lesion group and three-vessel lesion group.Using multi-group independent sample non-parametric test,it was found that the distribution of RDW among groups had statistical difference,and with the increase of lesion branches,the value of RDW increased gradually.4.Pearson correlation analysis showed that there was a negative correlation between Gensini integral and FMD,r=-0.776,P<0.05;there was a positive correlation between RDW and Gensini,r=0.262,P<0.05;there was a negative correlation between RDW and FMD,r=-0.241,P<0.05.5.The level of RDW in blood stasis syndrome group was higher than that in non-blood stasis syndrome group.Pearson correlation analysis showed that there was a positive correlation between RDW and the score of blood stasis syndrome,r=0.24,P<0.05.There was a positive correlation between RDW and syndrome score of blood stasis,r=0.277,P<0.05.Conclusions:1 Compared with the control group,the level of RDW in patients with coronary heart disease was significantly higher,and the level of RDW in stable angina pectoris group was lower than that in unstable angina pectoris group and acute myocardial infarction group,with statistical significance;there was no statistical difference in the level of RDW between unstable angina pectoris group and acute myocardial infarction group.2.The level of RDW is correlated with the number of coronary artery lesion branches.With the increase of the number of lesion branches,the level of RDW increases gradually.3.There is a linear correlation betw een FMD and RDW and Gensini integral.The lower FMD,the higher RDW,the higher Gensini integral.4.There is a negative correlation between RDW and FMD.5.The patients with blood stasis syndrome had higher RDW level.There was a linear relationship between RDW and blood stasis syndrome integral and blood stasis syndrome integral.There is a positive correlation between RDW and blood stasis syndrome score,and there is a positive correlation between RDW and blood stasis syndrome score.