红细胞分布宽度对系统性红斑狼疮疾病活动度评估的临床价值

The clinical value of red blood cell distribution width for assessing the severity of systemic lupus erythematosus

目的探讨系统性红斑狼疮(SLE)初诊患者红细胞分布宽度(RDW)与疾病严重程度间可能存在的关系。方法以190例健康人群作为对照组,回顾性分析初诊的181例SLE患者相关临床数据,如C-反应蛋白(CRP)、红细胞沉降率(ESR)、补体(C)、免疫球蛋白、红细胞分布宽度(RDW)、SLE疾病活动指数(SLEDAI-2K)等。依据国际通用的SLEDAI-2K准则评判SLE患者的疾病活动情况,对患者进行分组。分析各组间RDW指标的差异及SLEDAI-2K评分与RDW之间的相关性。结果 SLE患者的RDW明显高于对照组(t=16.36,P<0.001);SLE患者的RDW与ESR以及CRP呈正相关性(r=0.628、0.663,P<0.001),与C3及C4呈负相关性(r=-0.348、-0.273,P<0.001);RDW在SLE患者不同活动组间差异有统计学意义(F=99.66,P<0.001),且与SLEDAI-2K评分呈正相关性(r=0.725,P<0.001),4组间两两分别进行比较差异均有统计学意义(P<0.05)。结论 RDW具有潜在评估SLE初诊患者疾病活动度的临床价值。

Objective To analyze the relationship between the red blood cell distribution width（ RDW） and the severity of newly diagnosed patients with systemic lupus erythematosus（ SLE）. Methods The medical records of 181 patients of newly diagnosed systemic lupus erythematosus and 190 healthy controls were retrospectively analyzed,such as C-reactive protein（ CRP）,erythrocyte sedimentation rate（ ESR）,complement,immunoglobulin and RDW.In addition,SLE disease activity index 2000（ SLEDAI-2 K）,a global index based on the symptoms and laboratory findings,was calculated according to medical records for each patient. The RDW index between different groups were compared and the relationship between RDW and the SLEDAI-2 K score were analyzed. Results RDW was significantly higher in patients with SLE than that of control group（ t = 16. 36,P〈0. 001）. RDW was positively correlated with serum ESR,CRP and SLEDAI-2 K（ r = 0. 628,0. 663,0. 725,P〈0. 001） but negatively correlated with serum C3 and C4（ r =-0. 348,-0. 273,P〈0. 001）. A significant difference in RDW was found between different stages of activity groups in patients with SLE（ F = 99. 66,P〈0. 001） and there were also differences between any two for the four groups（ P〈0. 05）. Conclusion RDW may be a useful inflammatory index to estimate the disease activity of newly diagnosed patients with SLE.