红细胞分布宽度与慢性阻塞性肺疾病合并肺动脉高压的相关性

Relationship between red blood cell distribution width and chronic obstructive pulmonary disease with pulmonary hypertension

目的:研究红细胞分布宽度(RDW)与慢性阻塞性肺疾病(COPD)合并肺动脉高压的相关性。方法:收集呼吸科的120例COPD患者,采用心脏超声估算肺动脉压力(PSAP),根据患者是否存在肺动脉高压将研究对象分为A组(COPD合并肺动脉高压组66例)、B组(单纯COPD组54例),通过对两组患者红细胞分布宽度(RDW)、右室壁厚度(RVWT)、超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)、第1秒用力呼气量实测值占预计值百分比(FEV1%)、用力呼气量占用力肺活量比值[FEV1/FVC(%)]比较得出结论。结果:A组患者RDW、RVWT、hs-CRP、WBC均大于B组(P<0.05);A组患者FEV1%、FEV1/FVC(%)均小于B组(P<0.01);FEV1%、FEV1/FVC(%)与肺动脉高压呈负相关(rFEV1=-0.632,P=0.000;rFEV1/FVC=-0.406,P=0.000);RDW、RVWT、hs-CRP、WBC与肺动脉高压呈正相关(rRDW=0.860,P=0.000;rRVWT=0.673,P=0.000;rhs-CRP=0.438,P=0.000;rWBC=0.263,P=0.004);hs-CRP与RDW、RVWT存在正相关性(rRDW=0.425,P=0.000;rRVWT=0.421,P=0.000);WBC与RDW、RVWT存在正相关性(rRDW=0.342,P=0.000;rRVWT=0.324,P=0.000)。结论:RDW与COPD合并肺动脉高压存在相关性;RDW可以用来预测COPD相关肺动脉高压疾病严重程度,并对COPD患者预后起到一定的预测作用。

Objective：To explore the relationship between red blood cell distribution width （RDW） and chronic obstructive pulmonary disease （COPD） with pulmonary hypertension. Methods ：120 patients with COPD admitted in our hospital were collected. The pulmonary hypertension was detected by cardiac ultrasonography. According to the detection results, the patients were divided into group A （ COPD combined pulmonary hypertension group） and group B （ COPD group）. The red blood cell distribution width （ RDW）, right ventricular wall thickness （ RVWT）, hy- persensitive c - reactive protein （ hs - CRP） , white blood cell （ WBC ） , the first forced expiratory volume measured the percentage of the estimated value （FEV1% ） , forced expiratory volume ratio of forced vital capacity （FEV1/FVC （%）） were recorded. Results：RDW, RVWT, hs -CRP and WBC values in group A were significantly higher than those in group B （ P 〈0. 05） ; FEV1% and FEV1/FVC （ % ） in group A was lower than those in group B （ P 〈0. 01 ） ; FEV1% and FEV1/FVC （ % ） was negatively correlated with pulmonary hypertension （ rFEVl =-0. 632, P = 0. 000 ; r FEV1/FVC = - 0. 406, P = 0. 000 ） ; RDW, RVWT, hs - CRP and WBC was positively related with pulmonary hypertension （ r RDW = 0. 860, P = 0. 000 ; r RVWT = 0. 673, P = 0. 000 ; r hs- CRP = 0. 438, P -= 0. 000 ; r WBC = 0. 263, P = 0. 004） ; There was a positive correlation be- tween hs -CRP and RDW, RVWT （ r ROW = 0. 425, P --0. 000; r RVWT = 0. 421, P = 0. 000） ; WBC and RDW, RVWT were positively correla- ted （ r RDW = 0. 342, P = 0. 000 ; r RVWT = 0. 324, P = 0. 000）. Confusion ： RDW is associated with pulmonary hypertension in COPD. RDW can be used to predict the severity of COPD, and make predictive effect on the prognosis of patients with COPD.