红细胞分布宽度与膝骨关节炎的相关性研究

Association between red cell distribution width and knee osteoarthritis

目的探讨膝骨关节炎(KOA)患者的症状、膝关节结构与红细胞分布宽度(RDW)的相关性。方法回顾性队列研究。纳入安徽医科大学第一附属医院骨科2020年6月—2021年4月行手术治疗的81例KOA患者的临床资料。其中,男32例、女49例,年龄44~89(63±9)岁。患者根据Kellgren-Lawrence分级进行分组:2级为轻度组,3级或4级为重度组。患者术前均行患侧膝关节MR检查、RDW检测。观察指标:(1)比较2组患者的年龄、性别、体质量指数(BMI)、RDW等基本特征;(2)比较2组患者症状的加拿大西安大略和麦克马斯特大学关节炎指数(WOMAC)评分,以及膝关节结构指标软骨缺损评分、骨髓病变评分、髌骨指数、髌下脂肪垫体积、髌腱长度、软骨体积等的差异;(3)2组患者的RDW与WOMAC评分、膝关节结构指标的相关性采用Spearman相关分析。结果(1)重度组患者的年龄、RDW均高于轻度组,差异均有统计学意义(t=-2.77、Z=-2.08,P值均<0.05),2组患者性别、BMI差异均无统计学意义(P值均>0.05)。(2)重度组患者WOMAC评分、软骨缺损评分、骨髓病变评分分别为(107±15)、(36±3)、(25.8±4.8)分,均高于轻度组的(83±9)、(28±4)、(23.2±2.7)分,重度组患者的软骨体积为(13.78±1.90)cm^(3),低于轻度组患者的(15.18±2.04)cm^(3),差异均有统计学意义(t=-8.68、-9.89、-3.10、3.18,P值均<0.05)。(3)轻度组患者的RDW与髌骨指数、软骨体积呈负相关(r=-0.45、-0.42,P值均<0.05),与其他指标无相关性,重度组均无相关性(P值均>0.05)。结论在轻度KOA患者中,RDW与患者的髌骨指数、软骨体积呈负相关,可以在一定程度上提示膝关节软骨损伤的程度。

Objective To investigate the correlation between symptoms,knee structure,and red-cell distribution width(RDW)in patients with knee osteoarthritis(KOA).Methods A retrospective cohort study was conducted at the Department of Orthopedics,the First Affiliated Hospital of Anhui Medical University.Clinical data of 81 patients with KOA who underwent surgical treatment from June,2020 to April,2021 were collected.Among the patients,32 were males and 49 were females with age of 44-89(63±9)years.All patients were grouped based on Kellgren-Lawrence grading methods,with grade 2 classified as mild group and grade 3 or 4 classified as severe group.MR examination of the affected knee and measurement of RDW were completed before operation.Observation index:(1)Age,sex,body mass index(BMI),RDW,and other basic characteristics were compared between the two groups.(2)Western Ontario and McMaster University osteoarthritis index(WOMAC)scores,knee structural indicators such as cartilage defect scores,bone marrow lesions scores,Insall-Salvati ratio(ISR),volume of infrapatellar fat pad,length of patella tendon,and volume of cartilage were compared between the two groups.(3)Spearman rank correlation analysis was conducted to analyze the correlation between RDW,WOMAC scores,and knee structural indicators in both groups.Results(1)The age and RDW of the patients with severe group were higher than those of the patients with mild group,and the differences were statistically significant(t=-2.77,Z=-2.08,all P values<0.05).No significant difference was observed in gender and BMI(all P values>0.05).(2)WOMAC scores,cartilage defect scores,and bone marrow lesion scores in the severe group were(107±15),(36±3)and(25.8±4.8),which were higher than those in the mild group(83±9),(28±4)and(23.2±2.7),with statistical significance(t=-8.68,-9.89,-3.10;all P values<0.05).The volume of cartilage in the severe group was(13.78±1.90)cm3,which was lower than that in the mild group(15.18±2.04)cm3,with statistical significance(t=3.18,P<0.05).(3)In the mild group,RDW was negatively correlated with ISR and volume of cartilage(r=-0.45,-0.42,all P values<0.05),but it had no correlation with the other indicators.Furthermore,RDW had no correlation with all the indicators in the severe group(all P values>0.05).Conclusion In the patients with mild KOA,RDW values may indicate the degree of knee cartilage damage to a certain extent.