To Discuss The Relationship Between RDW With The Severity Of Coronary Artery Lesion In Patients With Coronary Arterry Disease And Risk Factors

Objective:Red blood cell volume distribution width (RDW) is a clinical test indexes reflect the heterogeneity of red blood cells in peripheral blood volume, and is measured by the blood cell analyzer-There are two display modes in Clinical blood cell analysis , i.e., the coefficient of variation of red blood cell distribution width (RDW - CV) and standard deviation of red blood cell distribution width (RDW - SD), mainly used for anemia of morphological classification and the diagnosis and differential diagnosis of iron deficiency anemia.In recent years,a growing number of studies have shown that RDW and heart failure, coronary heart disease, hypertension,atrial fibrillation and other cardiovascular disease are closely related.This study aimed to discuss the relationship between RDW with the severity of coronary artery lesion in patients with coronary artery disease and risk factors.Method:The research object are 160 cases,the patients undergoing coronary angiography examimation has received treatment in hospital .A detailed record of the patient's general condition (including gender, age, smoking history, always have high blood pressure, high cholesterol, diabetes, stroke and other medical history and family history of coronary heart disease), according to the result of coronary angiography patients divided into normal coronary angiography group (group A, n = 40) and coronary heart disease group (group B, n =120);According to the Gensini score ,coronary heart disease group is divided into three subgroups:the mild lesion group (B1 group, n = 40), moderate lesion group (B2 group, n = 42),highly lesion group (B3 group, n = 3 8).According to selected patients with RDW values range,divided the patients into three groups: low RDW group (RDW <12.1% , 56 cases);middle RDW group (12.1%<RDW ? 12.7%,52 cases) and high RDW group RDW (> 12.7%,52 cases).Collecting all the research objects fasting venous blood samples in the next morning ;The blood count and biochemical determination are completed in the clinical laboratory.We used W test, Levene, Wilcoxon sample rank text, one-way ANOVA, Kruskal-Wallis text, chi-square to analysis data by SPSS 13.0 statistics software , used Spearman rank correlation to analysis the multiple independent variables and the relationship between the RDW.Result:(1) By analyzing the data,the mean RDW-CV of four groups was (12.37 + 0.52) %,(12.42 + 0.55) %, (12.40 + 0.61) % and (13.13 + 1.50) %, showed a increasing trend.There has obvious difference of RDW-CV found between four groups (P < 0.001).Compared with group A, The increased RDW-CV in group B1 is not obvious, there was no statistically significant difference (P > 0.05);B2 group compared with group A, there was not statistically significant difference (P > 0.05);B3 group compared with group A, RDW-CV increased obviously, the difference was statistically significant (P < 0.05);(2) Coronary heart disease group of age,BMI,history of hypertension, diabetes, fasting blood sugar level, LDL - C, RDW - CV is higher than the level of the normal group ,the two groups can be thought of statistically significant difference(P < 0.05);(3) In every subgroup of coronary heart disease (CHD), as the degree of pathological changes is higher, the average concentration of red blood cells, Hb, fasting glucose, creatinine,RDW - CV is higher, and the more the number of patients with high blood pressure, the difference was statistically significant (P < 0.05);(4) low RDW group, RDW, high RDW group in comparison, the three indicatorsthe of average red blood cell volume, the average amount of red blood cells hemoglobin, acute myocardial infarction showed the difference was statistically significant (P < 0.05).With RDW-CV level increased, the incidence of acute myocardial infarction is also gradually increased;As for normal coronary angiography, its proportion is reduced gradually;(5) There were positive correlations between the RDW and red blood cells,Hb. (regression confficient = 0.493, 0.190, P < 0.05);There were negtive correlations between the RDW and average red blood cell volume,, the average amount of red blood cell hemoglobin(egression confficient?-0.235, -0.252, P < 0.05).Conclusion:(1) The RDW-CV is closely related to the degree of coronary heart disease, it is one of the predict factors the severity of coronary lesion index, the heavier of degree of coronary artery lesions, the higher of RDW values level. (2) The RDW is not associated with coronay heart disease (CHD) risk factors, its level is likely to be an independent risk factor for coronary heart disease lesion severity.