红细胞分布宽度与脑白质疏松的相关性研究

Correlation Between Red Blood Cell Distribution Width,RDW-to-Platelet Ratio and Leukoaraiosis

目的探讨脑白质疏松(leukoaraiosis,LA)的危险因素及红细胞体积分布宽度(red blood cell distribution width,RDW)、红细胞体积分布宽度/血小板计数(RDW-to-platelet ratio,RPR)与其的相关性。方法回顾性收集非急性期脑卒中患者279例作为研究对象,根据头磁共振分为脑白质疏松组(192例),非脑白质疏松组(87例)。记录患者的基本资料、实验室指标及影像学资料,计量资料采用t检验,计数资料采用χ^2检验进行组间比较,进一步采用二分类logistic回归模型分析LA的危险因素,通过受试者工作曲线(receiver operating curve,ROC)曲线预测RDW、RPR对LA发病风险。结果与非LA组比较,LA组在年龄、高血压、脑梗死、RDW、RPR差异有统计学意义(P<0.05),且经logistic回归分析提示年龄、高血压、脑梗死、RDW、RPR均为LA的独立危险因素。利用ROC曲线分析结果提示RDW曲线下面积0.649和RPR曲线下面积0.587,二者均大于0.5,说明RDW与RPR对于预测LA发病风险具有一定准确性,且RDW对于预测LA比RPR更有价值。RDW>12.55%时预测LA发病风险的灵敏度为89.1%,特异度为16.1%,ROC曲线下面积为0.649(95%CI 0.580~0.717,P<0.05)。结论年龄、高血压、脑梗死、RDW、RPR是LA的独立危险因素。ROC曲线分析提示RDW和RPR对于预测LA发病风险具有一定准确性,且RDW对于预测LA比RPR更有价值。

Objective To explore the risk factors of leukoaraiosis(LA)and the correlation between red blood cell distribution width(RDW),RDW-to-platelet ratio(RPR)and LA.Methods 279 patients with non-acute cerebral stroke were selected retrospectively and divided into LA group(192 cases)and non-LA group(87 cases)according to the head MRI examination.The basic information,laboratory indicators and imaging data of the patients were recorded.Measurement data was tested by t test,and counting data was compared between groups by Chi-Square Test.The risk factors of LA were further analyzed by binary logistic regression model.The receiver Operating Curve(ROC)was used to predict the risk of RDW and RPR on LA.Results Compared with non-LA group,there were statistically significant differences in age,hypertension,cerebral infarction,RDW and RPR in LA group(P<0.05).The Binary Logistic Regression Analysis showed that age,hypertension,cerebral infarction,RDW,RPR were independent risk factors of LA.ROC curve analysis showed that the area under curve of RDW was 0.649 and the area under curve of RPR was 0.587,both of which were greater than 0.5,indicating that RDW and RPR had certain accuracy in predicting the risk of LA,and that RDW was more valuable than RPR in predicting LA.When RDW was greater than12.55%,the sensitivity and specificity of predicting the risk of LA were respectively 89.1%and 16.1%,and the area under ROC curve was 0.649(95%CI 0.580-0.717,P<0.05).Conclusion Age,hypertension,cerebral infarction,RDW and RPR are independent risk factors of LA.ROC curve analysis shows that RDW and RPR have certain accuracy in predicting the risk of La,and RDW is more valuable in predicting LA than RPR.