364例类风湿关节炎患者红细胞分布宽度与炎症及免疫指标相关性的回顾性分析

Retrospective analysis of the correlation between red blood cell distribution width and anemia and inflammation indicators in 364 hospitalized patients with rheumatoid arthritis

目的探讨类风湿关节炎(RA)患者中红细胞分布宽度(red blood cell distribution width,RDW)的水平,观察贫血是否可影响RDW的水平,并分析RDW与RA患者炎症和免疫标志物的关系。方法回顾性分析2017~2019年住院的364例RA患者,根据贫血状况分为贫血组(n=201)和非贫血组(n=163)。比较两组红细胞其他参数[RDW、Hb、平均红细胞体积(MCV)]、RA相关炎症和免疫标志物[CRP、类风湿因子(RF)、红细胞沉降率(ESR)、血小板计数(BPC)、补体(C3、C4)、免疫球蛋白(IgA、IgG、IgM)]的差异及RDW与炎症和免疫标志物的相关性。结果 RA贫血组患者RDW、CRP、ESR、BPC、RF均高于非贫血组,差异有统计学意义(P<0.01);RDW与CRP、ESR、BPC、RF呈正相关,与Hb、MCV呈负相关,与C3、C4、IgG、IgA、IgM无明显相关性。结论贫血是影响RDW水平的因素之一,RDW水平与传统反映RA活动度的炎症和免疫标志物CRP、ESR、BPC、RF呈正相关,贫血患者尤为明显,RDW可作为除传统炎症和免疫标志物外的一个实验室指标,对RA的诊治起到一定作用。

Objective To explore the level of red blood cell distribution width(RDW) in patients with rheumatoid arthritis(RA),to explore whether anemia can affect the level of RDW,and to analyze the relationship between RDW and inflammation and immune markers in RA patients.Methods 364 RA patients hospitalized from 2017 to 2019 were retrospectively analyzed and divided into anemia group(n=201) and non-anemia group(n=163) according to anemia status.The other parameters of red blood cells[RDW,Hb,mean corpuscular volume(MCV)],RA related inflammation and immune markers[CRP,rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),blood platelet count(BPC),complement(C3,C4),immunoglobulin(IGA,IgG,IgM)] as well as the correlation between RDW and inflammation and immune markers were compared between the two groups.Results RDW,CRP,ESR,BPC and RF in the anemia group were all higher than those in the non-anemia group,difference was statistically significant(P<0.01).RDW was positively correlated with CRP,ESR,BPC and RF,negatively correlated with Hb and MCV,and it has no significant correlation with C3,C4,IgG,IgA and IgM.Conclusion Anemia is one of the factors affecting the level of RDW.The level of RDW is positively correlated with traditional inflammatory and immune markers that reflect RA activity,especially in anemia patients,and play a certain role in the diagnosis and treatment of RA.