红细胞体积分布宽度与血小板平均体积在强直性脊柱炎中的变化及其临床意义

Changes of Red Blood Cell Volume Distribution Width and Mean Platelet Volume in Patients with Ankylosing Spondylitis and Their Clinical Significances

目的观察强直性脊柱炎(AS)患者红细胞体积分布宽度(RDW)与血小板平均体积(MPV)的变化,探讨其临床意义。方法选取2014年1月—2016年1月就诊的128例AS患者为AS组,将Bath强直性脊柱炎疾病活动度指数(BASDAI)≥4分的78例患者设为活动组,BASDAI<4分的50例患者设为非活动组。并选取同期体检的健康人群128例设为对照组。比较AS组和对照组的RDW与MPV,以及活动组和非活动组的相关指标;分析AS患者RDW和MPV与红细胞沉降率(ESR)、C反应蛋白(CRP)、晨僵时间、BASDAI、血小板和血红蛋白的相关性。结果AS组RDW显著高于对照组,MPV显著低于对照组(P<0.01)。RDW与ESR、CRP、BASDAI呈正相关(P<0.05),与血红蛋白呈负相关(P<0.01);MPV与ESR、CRP和血小板呈负相关(P<0.05),与晨僵时间呈正相关(P<0.05)。活动组血红蛋白显著低于非活动组,RDW、CRP、ESR、晨僵时间高于非活动组(P<0.05,P<0.01)。结论 MPV和RDW与AS的疾病活动具有相关性,有望成为评估AS疾病活动程度的潜在指标。

Objective To observe changes of red blood cell volume distribution width（ RDW） and mean platelet volume（ MPV） in patients with ankylosing spondylitis（ AS） and to investigate their clinical significance. Methods A total of 128 AS patients admitted during January 2014 and January 2016 were selected as AS group,and then 78 patients with Bath ankylosing spondylitis disease activity index（ BASDAI） equal or larger than 4 points were selected as active subgroup,and other 50 patients with BASDAI less than 4 points were selected as inactive subgroup. A total of 128 healthy people taking physical examinations at the same period were selected as control group. RDW and MPV levels were compared between AS and control groups,and related indexes were also compared between active and inactive subgroups.Correlations between RDW with MPV and erythrocyte sedimentation rate（ ESR）,C reactive protein（ CRP）,early morning stiffness time,BASDAI,platelet and hemoglobin levels in AS patients were analyzed. Results In AS group,RDW level was significantly higher,while MPV level was significantly lower than those in control group（ P〈0. 01）. RDW was positively correlated with ESR,CRP and BASDAI（ P〈0. 05）,but it was negatively correlated with hemoglobin（ P〈0. 01）. MPV was negatively correlated with ESR,CRP and platelet（ P〈0. 05）,while it was positively correlated with early morning stiffness（ P〈0. 05）. In active subgroup,hemoglobin level was significantly lower,while levels of RDW,CRP,ESR and early morning stiffness were significantly higher than those in inactive subgroup（ P〈0. 05,P〈0. 01）.Conclusion MPV and RDW related to pathogenesis of AS,and they are possible to be potential indicators for assessing AS disease activity.