作者：邓勇，马晓峰，王红，曹建东，周巍

单位：

810012 青海省西宁市，青海省心脑血管病专科医院干部保健科；通信作者：邓勇，E-mail：23259478@qq.com

Units：

Department of Cadre Health Care，Qinghai Provincial Specialized Hospital for Cardiovascular and CerebrovascularDisease，Xining 810012，China；Corresponding author：DENG Yong，E-mail：23259478@qq.com

关键词：

冠状动脉慢血流现象；高原地区；藏族；汉族；红细胞；凝血功能；胆红素

Keywords：

Coronary slow flow phenomenon；Plateau area；Tibetan nationality；Han nationality；Red blood cell；Coagulation function；Bilirubin

CLC：

R 543.3

DOI：

DOI：10.3969/j.issn.1008-5971.2020.03.011

Funds：

基金项目：2017 年青海省卫生计生系统科研课题（2017-wjzd-03）

摘要：

背景　分析世居高原地区藏族、汉族冠状动脉慢血流现象（CSFP）患者凝血功能指标、红细胞相关指标及胆红素有助于了解世居高原人群 CSFP 特点及发病机制。目的　比较世居高原地区藏族、汉族 CSFP 患者凝血功能指标、红细胞相关指标及胆红素的差异。方法　选取 2014—2016 年在青海省心脑血管病专科医院干部保健科行冠状动脉造影并确诊为 CSFP 的患者 222 例，其中藏族患者 93 例（藏族组），汉族患者 129 例（汉族组）。比较两组患者及不同海拔高度藏族、汉族 CSFP 患者凝血功能指标〔包括凝血酶原时间（PT）和 D- 二聚体（D-Dimer）〕、红细胞相关指标〔包括红细胞计数（RBC）、血红蛋白（Hb）、红细胞比容（HCT）、平均红细胞体积（MCV）及红细胞分布宽度（RDW）〕、胆红素〔包括总胆红素（TBiL）、直接胆红素（DBiL）及间接胆红素（IBiL）〕。结果　（1）两组患者 RBC、Hb、HCT、DBiL 比较，差异无统计学意义（P>0.05）；汉族组患者 PT 短于藏族组，D-Dimer 低于藏族组，MCV、TBiL、IBiL 高于藏族组，RDW 小于藏族组（P<0.05）。（2）不同海拔高度藏族 CSFP 患者 D-Dimer、MCV、TBiL、DBiL、IBiL 比较，差异无统计学意义（P>0.05）。海拔高度较高的藏族 CSFP 患者 PT 长于海拔高度较低者，RDW 高于海拔高度较低者，RBC、Hb、HCT 高于海拔高度较低和中等者（P<0.05）。（3）不同海拔高度汉族CSFP 患者 PT、D-dimer、MCV、RDW、TBiL、DBiL 比较，差异无统计学意义（P>0.05）。海拔高度中等和较高的汉族 CSFP 患者 RBC、Hb、HCT 高于海拔高度较低者，海拔高度较高的汉族 CSFP 患者 RBC、Hb、HCT 及 IBiL 高于海拔高度中等者（P<0.05）。结论　世居高原地区藏族、汉族 CSFP 患者 PT、D-Dimer、MCV、RDW、TBiL、IBiL 存在差异。

Abstract：

Background　It is helpful to understand the characteristics and pathogenesis of coronary slow flowphenomenon（CSFP）by analyzing the indicators of coagulation function，erythrocyte related index and bilirubin in nativeTibetan and Han patients in plateau area. Objective　To compare the difference in indicators of coagulation function，erythrocyte related index and bilirubin between native Tibetan and Han patients with CSFP in plateau area. Methods　From2014 to 2016，a total of 222 patients with CSFP were selected in the Department of Cadre Health Care，Qinghai ProvincialSpecialized Hospital for Cardiovascular and Cerebrovascular Disease，thereinto 93 cases with Tibetan nationality were served asA group，the other 129 cases with Han nationality were served as B group. Indicators of coagulation function（including PT andD-dimer），erythrocyte related index（including RBC，Hb，HCT，MCV and RDW）and bilirubin（including TBiL， DBiLand IBiL）were compared between A group and B group，in Tibetan and Han nationality patients with different altitude. Results　（1）No statistically significant difference of RBC，Hb，HCT or DBiL was found between the two group（P>0.05）；PTin B group was statistically significantly shorter than that in A group，D-Dimer in B group was statistically significantly lowerthan that in A group，MCV，TBiL and IBiL in B group were statistically significantly higher than those in A group，RDWin B group was statistically significantly smaller than that in A group（P<0.05）.（2）No statistically significant differenceof D-Dimer，MCV，TBiL，DBiL，IBiL was found in Tibetan nationality patients with different altitude（P>0.05）.PT inTibetan nationality patients with higher altitude was statistically significantly longer than that in Tibetan nationality patients withlower altitude，RDW in Tibetan nationality patients with higher altitude was statistically significantly higher than that in Tibetannationality patients with lower altitude，meanwhile RBC，Hb and HCT in Tibetan nationality patients with higher altitude werestatistically significantly higher than those in Tibetan nationality patients with lower and medium altitude（P<0.05）.（3）Nostatistically significant difference of PT，D-Dimer，MCV，RDW，TBiL or DBiL was found in Han nationality patients withdifferent altitude（P>0.05）.RBC，Hb and HCT in Han nationality patients with medium and higher altitude were statisticallysignificantly higher than those in Han nationality patients with lower altitude，meanwhile RBC，Hb，HCT and IBiL in Hannationality patients with higher altitude were statistically significantly higher than those in Han nationality patients with mediumaltitude（P<0.05）.Conclusion　There is significant difference in PT，D-Dimer，MCV，RDW，TBiL and IBiL betweennative Tibetan and Han patients with CSFP in plateau area，respectively.

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