血红蛋白/红细胞分布宽度比值和红细胞分布宽度/血小板比值在类风湿关节炎病情评估中的应用

Assessment of hemoglobin-to-red cell distribution width ratio and red blood cell distribution width-to-platelet ratio to disease activity in rheumatoid arthritis patients

目的探讨类风湿关节炎(RA)患者外周血中血红蛋白/红细胞分布宽度比值(Hb/RDW)和红细胞分布宽度/血小板比值(RPR)与疾病活动度及疗效的关系。方法回顾性分析102例初诊RA患者(RA组)及与之年龄性别相匹配的103例健康体检者(对照组)的临床资料,计算Hb/RDW和RPR水平并进行比较。分析RA患者Hb/RDW和RPR与疾病活动度的相关性及治疗前后的差异。采用受试者工作特征(ROC)曲线探讨Hb/RDW和RPR对RA的辅助诊断作用。结果与对照组比较,RA组患者Hb/RDW水平明显降低,RPR水平明显升高(P<0.05)。随着28个关节疾病活动指数(DAS28)升高,RA患者Hb/RDW及RPR呈降低趋势(P<0.05)。RA组患者的Hb/RDW与ESR、CRP及DAS28均呈负相关(r=-0.381,r=-0.214,r=-0.319,P均<0.05),RPR与ESR、CRP及DAS28呈负相关(r=-0.295,r=-0.282,r=-0.278,P均<0.05)。规律治疗后的RA患者DAS28较治疗前明显降低,Hb/RDW和RPR较治疗前明显升高(P<0.05)。ROC曲线分析结果显示,Hb/RDW、RPR诊断RA的ROC曲线下面积分别为0.863(P<0.001)和0.567(P=0.098)。结论Hb/RDW可以作为RA疾病诊断的参考指标,Hb/RDW和RPR对RA患者疾病活动度及治疗效果的评估具有重要参考价值。

Objective To investigate the association between Hb/RDW and RPR to disease activity in rheumatoid arthritis(RA)patients.Methods A total of 102 RA patients(RA group)and 103 healthy subjects(control group)were enrolled.The hemoglobin-to-red cell distribution width ratio(Hb/RDW)and red blood cell distribution width-to-platelet ratio(RPR)were calculated and compared between two groups.Correlation of Hb/RDW and RPR with disease activity and difference of Hb/RDW and RPR before and after treatment in RA patients were analyzed.According to the Hb/RDW and RPR in RA patients,The receiver operating characteristic(ROC)curve were drawn to evaluate the diagnostic function of Hb/RDW and RPR in RA.Results The levels of Hb/RDW in RA group was decreased than those in control group while the RPR was increased(P<0.05).With the increase of DAS28,the Hb/RDW and RPR of RA patients decreased(P<0.05).Hb/RDW was negative correlated with ESR,CRP and DAS28 in RA patients(r=-0.381,r=-0.214,r=-0.319,all P<0.05),whereas RPR was negative correlated with ESR,CRP and DAS28(r=—0.295,r=—0.282,r=—0.278,all P<0.05).Furthermore,compare with DAS28 before treatment in RA patients,DAS28 score obviously decreased after treatment,whereas Hb/RDW and RPR obviously increased(P<0.05).In addition,the area under the ROC curve of Hb/RDW and RPR for diagnosis of RA was 0.863(P<0.001)and 0.567(P=0.098).Conclusion The Hb/RDW has good sensitivity and specificity for the diagnosis of RA.Hb/RDW and RPR may be helpful to assess the disease activity and to evaluate the treatment of RA patients.