红细胞分布宽度与慢性阻塞性肺疾病预后关系的系统评价与荟萃分析

Relationship between red blood cell distribution width and prognosis of chronic obstructive pulmonary disease: A systematic review and meta-analysis

目的评价红细胞分布宽度(RDW)与慢性阻塞性肺疾病(COPD)预后的关系。方法计算机检索PubMed、Embase、Cochrane、Web of science等数据库,检索日期为建库至2022年10月,利用Revman 5.4软件及Stata 17.0软件进行meta分析。结果初检243篇文献,经过筛选最终纳入20篇符合标准的文献,meta分析结果显示,COPD患者的RDW值高于健康人群(MD=-0.29,95%CI:-0.32~-0.26,Z=17.94,P<0.05),慢性阻塞性肺疾病急性加重(AECOPD)患者的RDW高于COPD患者(MD=-0.71,95%CI:-1.20~-0.22,Z=2.84,P<0.05),有不良结局的COPD及AECOPD患者的RDW高于无不良结局的COPD及AECOPD患者(MD=-1.61,95%CI:-2.12~-1.10,Z=6.18,P<0.05)。亚组分析显示,与存活患者相比死亡患者的RDW明显升高(MD=-1.55,95%CI:-2.03~-1.07,Z=2.84,P<0.05),与轻症患者相比症状较为严重的患者RDW明显升高(MD=-1.62,95%CI:-2.86~-0.38,Z=2.56,P<0.05)。结论RDW可能是COPD的有效预测指标,且在不良预后方面可能有更加重要的作用。

Objective To assess the relationship between red blood cell distribution width(RDW)and prognosis of chronic obstructive pulmonary disease(COPD).Methods Databases of PubMed,Embase,Cochrane,Web of science were searched from inception to October 2022,and meta analysis was performed with Revman 5.4 software and Stata 17.0 software.Results A total of 243 papers were initially reviewed,20 papers in compliance with the criteria were finally included upon screening.Meta analysis results showed that RDW value in COPD patients was higher than that in the healthy population(MD=-0.29,95%CI:-0.32--0.26,Z=17.94,P<0.05),RDW in acute exacerbation of COPD(AECOPD)patients was higher than that in COPD patients(MD=-0.71,95%CI:-1.20--0.22,Z=2.84,P<0.05),COPD and AECOPD patients with adverse outcomes had higher RDW than COPD and AECOPD patients without adverse outcomes(MD=-1.61,95%CI:-2.12--1.10,Z=6.18,P<0.05).Subgroup analysis showed that RDW was significantly higher in dead patients compared with surviving patients(MD=-1.55,95%CI:-2.03--1.07,Z=2.84,P<0.05),and RDW in patients with severer symptoms was significantly higher when compared to that in patients with milder symptoms(MD=-1.62,95%CI:-2.86--0.38,Z=2.56,P<0.05).Conclusions RDW is likely to be a valid predictor of COPD and has a more important role in poor prognosis.