红细胞分布宽度与阻塞性睡眠呼吸暂停低通气综合征病情和颈动脉内膜中层厚度的相关性

Relation of red blood cell distribution width with the severity and carotid intima media thickness of obstructive sleep apnea hypopnea syndrome

目的探讨OSAHS患者红细胞分布宽度（RDw）与病情严重程度和颈动脉粥样硬化的相关性。方法选取2013～2014年间在徐州医学院附属医院经多导睡眠监测（PSG）确诊的OSAHS患者103例，以及年龄、性别、体质量指数相匹配的28名健康对照者为研究对象，测定血RDW、红细胞计数（RBC）、血红蛋白（HB）、平均红细胞体积（MCV）等血常规参数，应用彩色多普勒超声仪检测颈动脉内膜中层厚度（IMT）；分析OSAHS组RDW与病情严重程度和颈动脉IMT之间的相关性。结果中度和重度OSAHS组患者RDW值较对照组明显升高（P值均〈0．05）；RDW与AHI呈正相关，而与最低SaO2呈负相关。轻度、中度、重度OSAHS组患者颈动脉IMT均明显高于对照组，而且不同病情OSAHS组之间差异均有统计学意义（P值均〈0．05）；颈动脉IMT和RDW水平呈正相关（r=0．52，P〈0．001）。结论OSAHS患者RDW升高，且与病情严重程度和颈动脉IMT呈正相关，提示RDW对评估OSAHS患者病情严重程度和发生颈动脉粥样硬化具有一定临床价值。

Objective To explore the relationship between red cell distribution （RDW） level with the severity and carotid intima media thickness of obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods A total of 103 patients with OSAHS diagnosed by polysomnography were selected from sleep Disorders Center at Affiliated Hospital of Xuzhou Medical College between January 2013 and August 2014. Twenty-eight healthy adult individuals matched for age and body mass index （BMI） were enrolled as the control group in this Study. The blood routine parameters including RDW, hemoglobin level, and mean corpuscular volume （MCV） were determined. The carotid intima-mesa thickness （IMT） was measured by color Doppler uhrasonography. In addition, the correlations were analyzed between RDW with the severity and carotid IMT of OSAHS. Results The RDW values were significantly increased in moderate to severe OSAHS patients compared to the controls （all P 〈0.05）. The RDW was positively correlated with AHI and negatively correlated with minimum SaO2. The carotid IMT was higher in milder to severe OSAHS patients than that in controls and there was a significant difference in carotid IMT among three OSAHS groups （all P 〈0.05）. RDW in OSAHS patients was positively correlated with carotid IMT（ r = 0. 52, P〈 0. 001）. Conclusions RDW was significantly increased in OSAHS patients and was positively correlatedwith the severity and carotid IMT of OSAHS. These findings suggest that RDW may be a predictive marker of OSAHS severity and carotid artery atherosclerosis in OSAHS.