外周血红细胞体积分布宽度与原发性闭角型青光眼的相关性研究

Association between the red blood cell distribution width with primary angle-closure glaucoma

目的:检测原发性闭角型青光眼(PACG)患者外周血红细胞体积分布宽度(RDW)变化水平。方法:采用回顾性病例对照研究。收集2019-02/2020-10在本院确诊的PACG住院患者306例和体检正常者126名。根据平均视野缺损(MD)大小,将PACG患者分为轻度组(MD≤6dB)、中度组(6<MD≤12dB)和重度组(MD>12dB)。收集纳入研究对象的眼科检查数据和人口学资料。采用全血细胞分析仪和全自动生化分析仪对外周血(RDW)、红细胞计数(RBC)、平均红细胞体积(MCV)、血红蛋白含量(HG)、白细胞计数(WBC)、谷丙转氨酶(ALT)和血清肌酐(Cr)等指标进行检测分析。结果:PACG组与对照组间年龄、性别、体质量指数、高血压和糖尿病疾病史无差异(P>0.05)。PACG组RDW水平(12.64%±0.96%)高于对照组(12.45%±0.49%)(t=2.132,P=0.034)。轻度PACG组RDW水平显著低于中度PACG组和重度PACG组(P<0.05)。Pearson相关分析显示,PACG组RDW水平与IOP(r=0.148,P=0.002)、MD(r=0.141,P=0.013)呈正相关、与MS(r=-0.154,P=0.007)呈负相关。多因素线性回归分析显示RDW对MD具有正向影响(β=1.405,P=0.018,95%CI:0.240~2.570)。结论:PACG患者RDW水平高于正常,且RDW水平可以评估PACG疾病进展情况。

AIM:To study the changes of the red blood cell volume distribution width(RDW)level and the correlation between them in patients with primary angle-closure glaucoma(PACG).METHODS:Retrospective case-control study was conducted.A total of 306 PACG patients in Eye&ENT Hospital of Fudan University from February 2019 to October 2020 were selected as the case group and 126 healthy patients who received physical examination at the hospital during the same period were selected as the control group.The PACG patients were divided into three subgroups according to the mean defect of visual field(MD):mild(MD≤6dB),moderate(6<MD≤12dB),and severe(MD>12dB).The detailed eye and physical examinations information of the two groups were collected from the medical data platform of Eye&ENT Hospital of Fudan University.The blood sample parameters were detected by automated hematology and biochemistry analyzers.Independent sample t-test,Chi-square test,one-way ANOVA test,Pearson correlation analyses and multiple linear regression analyses were performed in this research.RESULTS:There was no significant difference between the PACG group and the control group in age,gender,body mass index and blood pressure(P>0.05).Based on the laboratory results,the mean RDW level was significantly higher(t=2.132,P=0.034)in the PACG group(12.64%±0.96%)than that in the control group(12.45%±0.49%).Moreover,the mean RDW level and the mean hemoglobin(HG)level was significantly lower(P<0.05)in the mild PACG subgroup than that in the moderate and severe PACG subgroups.The Pearson correlation analyses showed a positive correlation between the MD and the RDW level(r=0.141,P=0.013),a significantly positive correlation between the IOP and the RDW level(r=0.148,P=0.002),and a negative correlation between the MS and the RDW level(r=-0.154,P=0.007)in patients with PACG.After adjusting for the confounding factors,multiple linear regression analyses showed a positive association between between the MD and the RDW level in patients with PACG(β=1.405,P=0.018,95%CI=0.240-2.570).CONCLUSION:The RDW level of PACG patients is higer than normal.The RDW level may help to predict the PACG patients’conditions for better treatments.