【摘要】 目的探讨冠状动脉旁路移植术(CABG)后晚期静脉移植血管病(SVGD)与血常规指标的关系。方法连续入选2015年3月—2016年1月于天津市胸科医院就诊并行静脉移植血管(SVG)的冠状血管造影术(CAG)检查的CABG术后超过1年的再发胸痛患者,将CABG术后SVG狭窄≥50%、除外吻合口狭窄的病变定义为SVGD,根据CAG结果,将患者分为SVGD组及非SVGD组。对比2组患者血常规化验结果,采用多因素Logistic回归分析血常规指标与晚期SVGD发生的关系。结果共入选患者148例,其中SVGD组109例、非SVGD组39例。对比发现SVGD组和非SVGD组红细胞分布宽度(RDW:0.123 2±0.008 9 vs.0.120 2±0.005 2)、中性粒细胞与淋巴细胞比值(NLR:3.40±2.11 vs.2.75±0.82)和血小板计数与淋巴细胞比值(PLR:143.10±54.70 vs.124.57±34.40)差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,RDW>0.127 5[OR(95%CI):4.905(1.058~22.747),P=0.042]、NLR>3.34[OR(95%CI):4.013(1.466~10.987),P=0.007]是晚期SVGD的独立危险因素,血小板比容(PCT)>0.185[OR(95%CI):2.636(1.098~6.324),P=0.030]可能成为晚期SVGD的危险因素。结论 RDW>0.127 5、NLR>3.34可提示晚期SVGD,PCT>0.185用于预测晚期SVGD需更大样本量的研究支持。更多还原

【Abstract】 Objective To investigate the correlation between blood routine test indicators and advanced saphenousvein graft disease(SVGD) in patients with coronary artery bypass grafting(CABG). Methods By defining SVGD as anocclusion of 50% or more of the saphenous vein graft(SVG) excluding distal anastomotic occlusion, patients were dividedinto SVGD group and non-SVGD group, who suffered CABG over 1 year with recurrent angina and underwent coronaryangiography(CAG) operation from March 2015 to January 2016 in Tianjin Chest Hospital. Results of blood routine test datawere compared between two groups. The multivariable Logistic regression was analyzed for the relationship between bloodroutine test indicators and advanced SVGD. Results There were 148 patients in the study, 109 patients in SVGD groupand 39 patients in non-SVGD group. There were significant differences in level of red blood cell distribution width(RDW:0.123 2±0.008 9 vs. 0.120 2±0.005 2, P<0.05), neutrophil/lymphocyte ratio(NLR: 3.40±2.11 vs. 2.75±0.82, P<0.05) andplatelet and lymphocyte ratio(PLR: 143.10±54.70 vs. 124.57±34.40, P<0.05) between SVGD group and non-SVGD group.Multivariable Logistic regression analysis showed that RDW>0.127 5[OR(95%CI): 4.905(1.058-22.747), P=0.042], NLR>3.34[OR(95%CI): 4.013(1.466-10.987), P=0.007]were independent risk factors for advanced SVGD, as well as PCT>0.185[OR(95%CI): 2.636(1.098-6.324), P=0.030]might be risk factor for advanced SVGD. Conclusion RDW>0.127 5, NLR>3.34 could indicate advanced SVGD. We need more samples to support that PCT>0.185 is used to be risk indicators foradvanced SVGD.更多还原