红细胞分布宽度与骨关节炎严重程度的关系

Relationship between red blood cell distribution width and severity of osteoarthritis

目的探讨骨关节炎(OA)患者的红细胞分布宽度(RDW)与病情严重程度的关系。方法回顾性分析2018年1月至2021年4月于该院确诊的259例OA患者的临床资料,根据入院首次检测的RDW水平中位数将OA患者分为低RDW组和高RDW组,比较两组临床资料,包括性别、年龄、白细胞计数(WBC)、淋巴细胞绝对值(LYM)、单核细胞绝对值(MONO)、中性粒细胞绝对值(NEU)、超敏C反应蛋白(hs-CRP)、红细胞沉降率(ESR)水平和视觉模拟评分法(VAS)评分。根据Kellgren-Lawrence(K-L)分级将OA患者分为轻中度组和重度组,比较不同OA严重程度患者的上述临床资料及RDW水平。分析RDW水平与K-L分级和VAS评分间的相关性。分析RDW单独及联合各项炎症相关指标诊断重度OA的效能。结果根据入院首次检测的RDW水平中位数,低RDW组有131例,高RDW组有128例。与低RDW组相比,高RDW组年龄、WBC、NEU、ESR、hs-CRP水平和VAS评分均升高,差异有统计学意义(P<0.05)。根据K-L分级,轻中度组有157例,重度组有102例。与轻中度组比较,重度组RDW、ESR、hs-CRP水平及VAS评分均升高,差异有统计学意义(P<0.05)。相关性分析结果显示,RDW水平与K-L分级和VAS评分均呈正相关(r=0.858、0.607,P<0.001)。RDW单独检测诊断重度OA的曲线下面积最大,为0.915,高于RDW+NEU、RDW+LYM、RDW+ESR、RDW+hs-CRP,灵敏度和特异度分别为87.3%和90.4%。结论RDW水平与OA患者的病情严重程度有关,可作为临床辅助评估OA病情严重程度的参考指标。

Objective To explore the relationship between the red blood cell distribution width(RDW)and the severity of the disease in patients with osteoarthritis(OA).Methods The clinical data of 259 OA patients confirmed in the hospital from January 2018 to April 2021 were retrospectively analyzed.According to the median RDW level first detected on admission,OA patients were divided into low RDW group and high RDW group.Clinical data of the two groups were compared,including gender,age,white blood cell count(WBC),lymphocyte absolute value(LYM),monocyte absolute value(MONO),neutrophil absolute value(NEU),hypersensitive C-reactive protein(hs-CRP),erythrocyte sedimentation rate(ESR)and visual analog scale(VAS)score.According to Kellgren-Lawrence(K-L)grade,OA patients were divided into mild to moderate group and severe group,and the above clinical data and RDW level of patients with different OA severity were compared.The correlations between RDW level and K-L grade,VAS score were analyzed.The diagnostic efficacy of RDW alone and in combination with inflammation-related indicators in the diagnosis of severe OA was analyzed.Results According to the median RDW level first detected on admission,131 patients were in the low RDW group and 128 patients were in the high RDW group.Compared with those in low RDW group,the age,WBC,NEU,ESR,hs-CRP levels and VAS score in high RDW group increased,the differences were statistically significant(P<0.05).According to K-L grade,there were 157 cases in mild to moderate group and 102 cases in severe group.Compared with mild to moderate group,the levels of RDW,ESR,hs-CRP and VAS score in severe group were significantly higher,the differences were statistically significant(P<0.05).The results of correlation analysis showed that the RDW level correlated positively with K-L grade and VAS score(r=0.858,0.607,P<0.001).The area under the curve of RDW alone in the diagnosis of severe OA was the highest,which was 0.915,higher than that of RDW+NEU,RDW+LYM,RDW+ESR,RDW+hs-CRP,with sensitivity and specificity of 87.3%and 90.4%respectively.Conclusion The level of RDW relates to the severity of OA patients and might be used as a reference index for clinical auxiliary assessment of the severity of OA.