红细胞分布宽度在慢阻肺合并肺动脉高压中的临床价值

The clinical significance of red blood cell distribution width in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)患者红细胞分布宽度(RDW)的变化特征及其与肺动脉高压的关系。方法收集2015年12月至2016年4月阜阳市人民医院医院呼吸科住院的67例COPD患者资料,其中合并肺动脉高压者20人,未合并肺动脉高压者47人,对病史资料及RDW进行统计分析,比较两组组间差异。结果与非肺动脉高压组相比,肺动脉高压组RDW明显增高(t=3.013,P=0.004),RDW异常增高的比例也高于非肺动脉高压组(χ2=6.489,P=0.011),RDW异常增高是COPD合并肺动脉高压的独立危险因素(OR=11.5,95%CI:1.195~110.640,P<0.05)。根据ROC曲线,RDW取最佳界值12.85%时,其对COPD肺动脉高压诊断的敏感度及特异度分别为45.0%和80.9%。结论 RDW对COPD合并肺动脉高压具有良好的预测价值。

Objective To study the changing characteristics of red cell distribution width（RDW）in patients with chronic obstructive pulmonary disease（COPD）,and its relations with pulmonary hypertension. Methods Clinic data of 67 patients diagnosed with COPD at People′s Hospital of Fu Yang were collected from December 2015 to April 2016. Among all the patients,20 patients were diagnosed with pulmonary hypertension and 47 patients without pulmonary hypertension. Clinical data and RDW were analyzed to explore the differences between the two groups. Results Compared with patients without pulmonary hypertension,COPD patients with pulmonary hypertension had higher level of RDW（t=3.013,P=0.004）,and its ratio of abnormal increase of RDW was also higher（χ～2=6.489,P=0.011）. Abnormal increase of RDW was a risk factor for pulmonary hypertension in COPD patients（OR=11.5,95%CI：1.195～110.640,P〈0.05）. According to receiver operating characteristic curve,the cut-off value of RDW was 12.85%,the diagnostic sensitivity and specific degrees of pulmonary hypertension in COPD patients were 45.0% and 80.9%,respectively. Conclusion RDW is a valuable diagnostic indicators of pulmonary hypertension in patients with COPD.