红细胞分布宽度和血清胱抑素C对COPD继发肺动脉高压的预判价值比较

Comparison of red blood cell distribution width and serum cystatin C in predicting pulmonary hypertension secondary to chronic obstructive pulmonary disease

目的比较红细胞分布宽度（RDw）和血清胱抑素C（Cys-C）对COPD继发肺动脉高压的预判价值。方法纳入2014年5月至2016年4月就诊的114例单纯COPD患者和66例COPD合并肺动脉高压患者，测量其血清RDW和Cys-C水平，比较并评价它们对肺动脉高压的预测价值。结果合并组患者的血清RDW和Cys-C水平均显著高于单纯COPD患者（P〈O．05）；RDW和Cys-C预测COPD合并肺动脉高压的准确性均是74％，两者的敏感性、特异性和准确性等指标差异均无统计学意义（P〉O．05）；血清RDW水平与肺动脉压力呈正相关（r=0．416，P=0．002），Cys-C水平与肺动脉高压的严重程度无显著相关性（r=0．225，P=0．307）。结论虽然RDW和Cys-C对COPD合并肺动脉高压的预测准确性无明显差别，但RDW与肺动脉压力显著相关，因此在临床中更具应用价值。

Objective To compare the red blood cell distribution width （RDW） and serum cystatin C （Cys-C） in predicting pulmonary hypertension secondary to chronic obstructive pulmonary disease （COPD）. Methods One hundred and fourteen patients with COPD and 66 COPD patients with pulmonary hypertension from May 2014 to April 2016 were enrolled in this study, their serum RDW and Cys-C levels were measured and compared to evaluate their predictive value for pulmonary hypertension. Results The RDW and Cys-C levels in the pulmonary hypertension group were significantly higher than those in the COPD patients （ P ~ 0.05）. The accuracy of RDW and Cys-C in predicting COPD with pulmonary hypertension was 74 G, and their sensitivity, specificity, and accuracy were no difference （ P〉.05）. RDW was positively correlated to the pulmonary artery pressure （ r = 0. 416, P = 0. 002）, while Cys-C was not correlated to the severity of pulmonary hypertension （ r =0. 225, P =0. 307）. Conclusions Although RDW and Cys-C have no significant difference in predictive of COPD with pulmonary hypertension, RDW is significantly associated with pulmonary artery pressure, so it is more valuable in clinical practice.