红细胞体积分布宽度(RDW)与类风湿关节炎(RA)病情活动的相关性分析

Relation between red blood cell distribution width(RDW) and disease activity of rheumatoid athritis(RA)

目的探索红细胞体积分布宽度(red blood cell distribution width,RDW)与类风湿关节炎(rheumatoidarthritis,RA)病情活动的相关性。方法按照1987年美国风湿病学会修订的RA分类标准筛选出2008年7月至2010年10月间复旦大学附属中山医院风湿内科收治的89例RA患者,收集疾病状况相关的临床资料(关节肿胀、疼痛、患者对疾病总体评价等)、血常规、红细胞沉降率(erythrocyte sedimentation rate,ESR)、高敏C反应蛋白(highsensitivity C-reactive protein,hs-CRP)及类风湿因子(rheumatioid factor,RF)等实验室指标。以ESR40mm/h和hs-CRP 5mg/L为界分为高炎症组和低炎症组,以Hb 110g/L为界分为贫血组和非贫血组,分别比较两组的RDW水平,并对RDW与ESR、hs-CRP及疾病活动性评分DAS28行相关性分析。结果高炎症组患者的RDW水平为(14.88%±1.80%),明显高于低炎症组患者(14.14%±1.45%)(P=0.04)。RDW与ESR、hs-CRP、DAS28-ESR、DAS28-CRP和健康评定问卷(health assessment questionnaire,HAQ)有明显相关性,rho值分别为0.22、0.27、0.25、0.24和0.34(P均<0.05),RDW与ESR、log hs-CRP和HAQ有线性回归关系。排除贫血因素后,RDW与上述疾病活动指标无相关性。结论 RA患者的RDW与疾病活动性存在相关关系,这种相关性可能受到贫血因素的影响。

Objective To assess whether red blood cell distribution width （RDW） is associated with disease activity of rheumatoid Rathritis （RA）. Methods We selected 89 RA patients visited in Depratment of Rheumatology, Zhongshan Hospital from Jul. 2008 to Oct. 2010. The levels of highsensitivity C-reactive protein （hs-CRP）, erythrocyte sedimentation rate （ESR） and RDW were measured,and the disease activity index （such as HAQ and DAS28） were made by doctors of rheumatology. The enrolled patients were divided into heavy inflammatory and light inflammatory groups on the basis of ESR （40 ram/h） and hs-CRP （5 rag/L）, and were divided into anemic and nonanemic groups according to Hb （110 g/L）. Differences of RDW among groups were evaluated by t test and relations between variables were assessed by Spearman correlation analysis as that of light inflammatorywell as linear regression analysis. Results RDW levels of heavy inflammatory group （14.88%± 1. 800//00） was higher than group （14. 14% ± 1.45% ,P= 0.04）. RDW was significantly associated with ESR,hs-CRP, HAQ,DAS28 （ESR） and DAS28 （CRP）, the value of rho were 0. 22,0. 27,0. 25,0. 24 and 0. 34, respectively, （all P〈0. 05）. ESR, log hs-CRP and HAQ were positively correlated with RDW （all P〈 0.05）. There was no association between RDW and the previous index excluding the factor of anemia. Conclusions RDW was significantly associated with the disease activity of RA, but the association may be affected by anemia.