系统性红斑狼疮病情活动的潜在标志物:红细胞分布宽度变异系数

Potential marker of systemic lupus erythematosus activity:variation coefficient of red cell distribution width

目的分析RDW-CV(红细胞分布宽度变异系数)在初发女性SLE(系统性红斑狼疮)患者外周血中的表达模式,探讨其在SLE中的临床意义。方法采取横断面研究,回顾性纳入91例初发女性SLE患者,以血红蛋白110 g/L为界限分为非贫血组(na-SLE,Hb≥110 g/L,n=51)和贫血组(a-SLE,Hb<110 g/L,n=40),以SLEDAI-2K 6为界限分为活动组(2K≥6,n=46)和缓解组(2K<6,n=45)。Mann-Whitney U与Kruskal-Wallis H检验检测RDW-CV在SLE各组和健康对照组(HC)间及SLE各组间的表达。结果 RDW-CV在All-SLE(所有SLE)组表达明显高于HC组,且a-SLE组较na-SLE组明显升高,差异有统计学意义。RDW-CV在na-SLE中,活动组较缓解组表达明显升高,差异有统计学意义,而在All-SLE、a-SLE中,活动组与缓解组相比差异无统计学意义。Spearman相关分析显示:在All-SLE中,RDW-CV与SLEDAI-2K、ANA呈正相关(P<0.05);与总淋巴细胞数、NK细胞(%)、补体C3、血沉(ESR)、红细胞计数(RBC)、血红蛋白量(Hb)呈负相关(P<0.05);在a-SLE中,RDW-CV与RBC、Hb呈负相关(P<0.05),而与其他指标无关;在na-SLE中,RDW-CV与SLEDAI、ANA、ds-DNA、CD8+T细胞(%)呈正相关(P<0.05)。结论 RDW-CV在临床上与ANA、ds-DNA相关,可能通过淋巴细胞及其亚群参与SLE的发生发展,可以作为评估SLE疾病活动有希望的候选者,但有时又仅限于na-SLE患者,当SLE患者同时存在贫血时,RDW-CV对SLE疾病活动的影响可能被覆盖。

Objective To investigate the expression pattern of RDW-CV(Variation Coefficient of Red Cell Distribution Width)in peripheral blood of patients with newly diagnosed SLE(Systemic Lupus Erythematosus)and to explore its clinical significance in SLE.Methods A cross-sectional study was performed retrospectively into 91 patients with newly diagnosed SLE who were divided into non-anemia group(na-SLE,Hb≥110 g/L,n=41)and anemia group(a-SLE,Hb<110 g/L,n=50)with hemoglobin 110 g/L as the boundary,and were divided into active group(2 K≥6,n=45)and remission group(2 K<6,n=46)with SLEDAI-2 K 6 as the limit.Mann-Whitney U/Kruskal-Wallis H test was used to detect the expression of RDW-CV in each group of SLE and healthy control group(HC)and between SLE groups.Results The expression of RDW-CV in the All-SLE(all SLE)group was significantly higher than that in the HC group,and the a-SLE group was significantly higher than the na-SLE group,and the difference was statistically significant;In na-SLE,the expression of RDW-CV in the active group was significantly higher than that in the remission group,and the difference was statistically significant.In All-SLE and a-SLE,there was no significant difference in activity and remission;Spearman correlation analysis showed that RDW-CV was positively correlated with SLEDAI-2 K and ANA in All-SLE(P<0.05);total lymphocyte count,NK cells,complement C3,Erythrocyte Sedimentation Rate(ESR),red blood cell count(RBC),hemoglobin quantity(HB)was negatively correlated(P<0.05);in a-SLE,RDW-CV was negatively correlated with RBC and HB(P<0.05),but not related to other indicators;in na-SLE,RDW-CV was positively correlated with SLEDAI,ANA,ds-DNA,CD8+T cells(P<0.05).Conclusion RDW-CV is clinically associated with ANA and ds-DNA;it may be involved in the development of SLE through lymphocytes and their subpopulations,and may be a promising candidate for assessing SLE disease activity.