Analysis Of Influence Factors And The Relationship Between Red Cell Distribution Width And Short Term Prognosis Of Acute Ischemic Stroke

Objectives Investigate the relationship between red blood cell distribution width(RDW) and one month prognosis in patients with acute ischemic stroke. And find out the influence factors of RDW.Methods Continuously collected 487 patients with acute ischemic stroke from January, 2014 to October, 2015 in the department of neurology of Qian’an People’s Hospital and screened 229 cases which met the inclusion criteria. The diagnosis and treatment of all cases are in line with the principles of the 2010 Chinese acute ischemic stroke diagnosis and treatment guidelines. Collected the basic data from all subjects, including age, sex, smoking history, drinking history, past medical history(history of hypertension, diabetes, coronary heart disease and stroke), etc. Venous blood samples were collected within 24 h after admission and tested the blood biochemistry indexes which including the value of RDW. At one month after onset, using the m RS scale to evaluated the degree of the patient’s disability. Good prognosis was defined as m RS ≤2, and poor prognosis was defined as m RS>2. Statistical analysis was performed by SPSS22.0 software. According to the median of RDW, all patients were divided into two groups, and then compared the difference of variables and the ratio of poor prognosis between two groups. Using the chisquare test to compare the categorical data. The normality test showed that the measurement data was normally distributed and using t-test for comparison. The prognosis as the dependent variable, using multivariate logistic regression to analyze factors which affecting one month prognosis of acute ischemic stroke patients. Using the pearson correlation analysis to analyze the correlation between RDW and other variables, and using the multiple linear regression to analyze the factors which affecting the RDW.Results 1 In the group of high level of RDW, patients exhibited higher mean age, SBP, admission NIHSS score and ratio of diabetes history. Compared with the low level group, patients in the high level group exhibited higher hs-CRP, Hcy, TC, LDL, BUN and Cr among the laboratory indicators(P<0.05). But in the high level group, the value of Hct, Hb and Alt were lower than patients in the low level group(P<0.05). 2 Compared with the low level group, the ratio of poor prognosis in high level group was significantly increased(68.4% vs 15.3%, P<0.01). 3 Multivariate Logistic regression analysis showed that gender, SBP, WBC, BUN, RDW, hs-CRP, Hcy and admission NIHSS score were the influence factors for prognosis of acute ischemic stroke at one month after onset(P<0.05). 4 Pearson correlation analysis showed that, the relationship of RDW values and admission NIHSS score was a significant positive correlation(r=0.335, P=0.000). RDW was also positively correlated with age, MVC, hs-CRP, Hcy, Cr, BUN and TC(P<0.05). 5 The multiple linear regression analysis showed that age, hs-CRP and cholesterol are influence factors of RDW(P<0.05), and their standardized regression coefficient were 0.200, 0.327 and 0.129.Conclusions 1 RDW is an influence factor for prognosis in patients with acute ischemic stroke at one month after onset. 2 In patients with acute ischemic stroke, age, hs-CRP and cholesterol are the influence factors of RDW.