慢性阻塞性肺疾病稳定期患者血清红细胞分布宽度与BODE指数相关性研究

Relationship between serum red cell distribution width and BODE index in patients with stable chronic obstructive pulmonary disease

目的探讨红细胞分布宽度(red cell distribution width,RDW)与慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者BODE指数的相关性。方法 110例COPD稳定期患者为COPD组,其中肺功能分级Ⅰ级43例,Ⅱ级34例,Ⅲ级24例,Ⅳ级9例;体检健康者48例为对照组;检测2组血氧饱和度、血清RDW、C反应蛋白水平、BODE指数,并进行血气分析。结果COPD组RDW值[(14.88±1.63)%]明显高于对照组[(13.00±1.11)%](P<0.05);COPD组肺功能Ⅳ级患者RDW值[(15.30±4.18)%]高于Ⅲ级[(14.10±1.82)%]、Ⅱ级[(13.60±3.03)%]和Ⅰ级[(12.90±2.47)%]患者(P<0.05),Ⅲ级患者高于Ⅱ级和Ⅰ级患者(P<0.05),Ⅱ级患者与Ⅰ级患者比较差异无统计学意义(P>0.05);RDW>14.3%患者第1秒用力呼气量[(1.33±1.12)L]、第1秒用力呼气量占预计值百分比[(53.20±0.45)%]、第1秒用力呼气量/用力肺活量[(51.29±0.60)%]、6min步行距离[(390.65±2.21)m]、血氧饱和度[(94.21±3.47)%]均低于RDW≤14.3%患者[(1.92±2.03)L、(66.03±0.96)%、(59.60±1.36)%、(433.02±1.68)m、(97.00±3.63)%](P<0.05),吸烟者比率(64.10%)和BODE指数[3.05(2.69,3.41)]高于RDW≤14.3%患者[52.11%、2.16(1.31,3.01)](P<0.05);COPD患者RDW值与6min步行距离、第1秒用力呼气量占预计值百分比、第1秒用力呼气量/用力肺活量、血氧饱和度呈负相关(r=-0.169,P<0.001;r=-0.210,P<0.001;r=-0.296,P<0.001;r=-0.190,P<0.001),与年龄、CRP、BODE指数呈正相关(r=0.182,P<0.001;r=0.299,P<0.001;r=0.400,P<0.001)。结论 COPD患者RDW值与BODE指数、CRP密切相关,可通过RDW值预测COPD的严重程度。

Objective To analyze the relationship of serum red cell distribution width(RDW)with body mass index,airflow obstruction,dyspnea and exercise capacity index(BODE)index in patients with stable chronic obstructive pulmonary disease(COPD).Methods The levels of oxygen saturation,serum RDW,C-reactive protein and BODE index were detected and blood gas analysis was done in 110 stable COPD patients(COPD group)including 43 patients with lung function stageⅠ,34 with stageⅡ,24 with stageⅢ and 9 with stageⅣ,and 48 healthy volunteers(control group).Results The RDW was significantly higher in COPD group((14.88±1.63)%)than that in control group((13.00±1.11)%)(P<0.05).The RDW was significantly higher in patients with lung function stageⅣ((15.3±4.18)%)than that in patients with stageⅢ((14.10±1.82)%),stageⅡ((13.60±3.03)%)and stageⅠ((12.90±2.47)%)(P<0.05),in patients with stageⅢthan that in patients with stageⅡ and stageⅠ(P<0.05),and there was no significant difference between the patients with stage Ⅱ and stage Ⅰ(P>0.05).The forced expiratory volume in one second(FEV1)((1.33±1.12)L),percentage of predicted value of FEV1(FEV1%pred)((53.20±0.45)%),percentage of FEV1 in force vital capacity(FEV1/FVC)((51.29±0.60)%),6 min walking distance((390.65±2.21)m)and oxygen saturation((94.21±3.47)%)were significantly lower in patients with RDW >14.3% than those in patients with RDW≤14.3%((1.92±2.03)L,(66.03±0.96)%,(59.60±1.36)%,(433.02±1.68)m,(97.00±3.63)%)(P<0.05),and the smoking proportion(64.10%)and BODE index(3.05(2.69,3.41))in patients with RDW>14.3%were significantly higher than those in patients with RDW≤14.3%(52.11%,(2.16(1.31,3.01))(P<0.05).The RDW was negatively correlated with 6 min walking distance,FEV1% pred,FEV1/FVC and oxygen saturation(r=-0.169,P<0.001;r=-0.210,P<0.001;r=-0.296,P<0.001;r=-0.190,P<0.001),and positively correlated with the age,C-reactive protein and BODE index(r=0.182,P<0.001;r=0.299;P<0.001;r=0.400,P<0.001).Conclusion RDW is closely correlated with BODE index and C-reactive protein in patients with COPD,and can be used to predict the severity of COPD.