结直肠腺瘤患者外周血红细胞分布宽度的应用价值分析

Value analysis of red blood cell distribution width in patients with colorectal adenoma

目的探讨结直肠腺瘤患者外周血红细胞分布宽度(RDW)的临床应用价值。方法回顾性收集郑州大学第一附属医院2019年6月至2021年6月行结肠镜检查初次确诊的197例结直肠腺瘤患者血常规及临床病理资料,以同期健康体检者172例作为对照。采用受试者工作特征曲线寻找RDW诊断结直肠腺瘤的最佳截断值,根据截断值将结直肠腺瘤患者分为高RDW组和低RDW组,比较2组临床病理资料。采用Logistic回归分析筛选结直肠腺瘤患者RDW升高有关因素。结果结直肠腺瘤组患者红细胞、血小板计数、淋巴细胞绝对值、平均红细胞血红蛋白浓度低于对照组(Z=3.889,P<0.001;Z=2.766,P=0.006;Z=3.015,P=0.003;Z=3.972,P<0.001),结直肠腺瘤组患者外周血RDW显著高于对照组(Z=13.646,P<0.001)。RDW与结直肠腺瘤组患者年龄、腺瘤数目、腺瘤直径有关(t=2.491,P=0.014;χ^(2)=7.317,P=0.007;χ^(2)=10.062,P=0.002)。Logistic回归分析发现高龄和腺瘤的数目多、直径大与RDW升高有关(OR=2.214,95%CI:1.125~4.358,P=0.021;OR=2.302,95%CI:1.171~4.528,P=0.016;OR=2.260,95%CI:1.082~4.723,P=0.030;OR=4.980,95%CI:1.635~15.171,P=0.005)。结论RDW可作为结直肠腺瘤诊断和评估病情的指标。

Objective To analyze the value of red blood cell distribution width in peripheral blood of patients with colorectal adenoma.Methods The blood routine and clinicopathological data of 197 patients with colorectal adenoma firstly diagnosed by colonoscopy from June 2019 to June 2021 in the firstly Affiliated Hospital of Zhengzhou University were collected retrospectively.Another 172 healthy volunteers who underwent physical examination in the same period were taken as the control group.The patients were divided into the high-RDW group and with low-RDW group according to RDW cut-off value based on receiver operating characteristic curve.The clinicopathological data were compared between the two groups.Logistic regression analysis model was used to screen the factors related to the increased RDW value in patients with colorectal adenoma.Results The red blood cell,platelet count,absolute value of lymphocytes and mean cell hemoglobin concentration in the colorectal adenoma group were lower than those in the control group(Z=3.889,P<0.001;Z=2.766,P=0.006;Z=3.015,P=0.003;Z=3.972,P<0.001).The median value of RDW in peripheral blood of the colorectal adenoma group was significantly higher than that of the control group(Z=13.646,P<0.001).RDW value was associated with age,number and size of adenomas(t=2.491,P=0.014;χ^(2)=7.317,P=0.007;χ^(2)=10.062,P=0.002).Logistic regression model revealed that advanced age and the number and size of adenomas were related to the increased RDW value(OR=2.214,95%CI:1.125~4.358,P=0.021;OR=2.302,95%CI:1.171~4.528,P=0.016;OR=2.260,95%CI:1.082~4.723,P=0.030;OR=4.980,95%CI:1.635~15.171,P=0.005).Conclusion RDW value can be used as a biological marker for the diagnosis and evaluation of colorectal adenomas.