红细胞分布宽度在不同分级慢性阻塞性肺疾病患者中的变化及意义

Changes and significance of red cell distribution width in patients with chronic obstructive pulmonary disease at different levels

目的探讨红细胞分布宽度(RDW)在不同分级慢性阻塞性肺疾病(COPD)患者中的变化特点及意义。方法选取2013年1月—2015年1月四川省攀枝花市第二人民医院呼吸内科收治的COPD患者80例为研究对象,根据病情分级将患者分为A组(0级)、B组(Ⅰ级)、C组(Ⅱ级)和D组(Ⅲ级)各20例。对比4组患者的RDW、血红蛋白(Hb)、红细胞计数(RBC)、白细胞计数(WBC)、脑钠肽(BNP)、C反应蛋白(CRP)、二氧化碳分压(PaCO_2)、氧分压(PaO_2),并分析Ⅲ级COPD患者的相关因素。结果 4组患者的Hb、RBC比较差异无统计学意义(P>0.05)。RDW、WBC、BNP、CRP和PaCO_2D组>C组>B组>A组,PaO_2水平A组>B组>C组>D组,差异均有统计学意义(P<0.05)。Ⅲ级COPD患者的RDW与氧分压呈负相关(r=-0.39.5,P<0.01),与BNP和CRP均呈正相关(r=0.783、0.362,P<0.05)。结论 COPD患者的RDW与PaO_2呈负相关,且能够较好地反映患者机体炎性反应水平,可以作为评价COPD患者病情严重程度的指标。

Objective To explore the changes of red cell distribution width（RDW） in patienls with chronic obstructive pulmonary disease（COPD） at different levels and its significance.Methods From January 2013 to January 2015,80 patients with COPD in Panzhihua City,Sichuan Province were divided into group A（grade 0）,group B（grade Ⅰ）,group C（grade Ⅱ） and group D（grade Ⅲ）.Compared the four groups of patients＇ RDW,hemoglobin（Hb）,red blood cell count（RBC）,white blood cell count（WBC）,brain natriuretic peptide（BNP）,C-reactive protein（CRP） and carbon dioxide into pressure（PaCO2） oxygen partial pressure（PaO2）,and factors related to the grade Ⅲ patients with chronic obstructive pulmonary disease（COPD）.Results The 4 groups had no statistically significant difference of Hb and RBC（P〈0.05）.RDW,WBC,BNP,CRP and PaCO2 in the order of group D 〉group C 〉group B 〉group A,Level of PaO2 in the order of group A group B group C group D,the difference has statistical significance（P〈0.05）.Class Ⅲ chronic obstructive pulmonary disease（COPD） patients＇ RDW and oxygen points pressure was negative correlated（r =-0.395,P〈0.01）.and BNP and CRP were positively correlaled（r = 0.783.r = 0.362,P〈0.05）.Conclusion It proved that the COPD patient＇s RDW and PaO2 showed negative correlation,and can better reflect the patient＇ s inflammatory reaction level,it can be used as severity index for patients with COPD.