红细胞分布宽度与慢性阻塞性肺疾病所致肺动脉高压的相关性分析  

Correlation study between RDW and pulmonary hypertension in patients with chronic obstructive pulmonary disease

作　　者：王丽红[1] 袁林栋 刘晓宇[1] 孙武装[1] 

机构地区：[1]河北医科大学第一医院呼吸内科,河北石家庄050031 [2]山东省聊城市人民医院呼吸内科,山东聊城252000

出　　处：《河北医科大学学报》2017年第7期756-759,共4页Journal of Hebei Medical University

摘　　要：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)所致肺动脉高压的相关性。方法门诊随诊的稳定期COPD患者198例,根据心脏彩色超声估算肺动脉收缩压(pulmon aryarterial systolic pressure,PASP),并根据PASP分为重度肺动脉高压组(PASP>70mmHg)45例,中度肺动脉高压组(PASP>50~70mmHg)50例,轻度肺动脉高压组(PASP 35~50mmHg)47例,正常肺动脉压组(PASP<35 mmHg)56例,选取同期健康体检者50例为对照组,检测各组RDW、肺功能、血气分析并进行比较。结果 RDW、PaCO_2随PASP严重程度增高而升高,其中PaCO_2在正常肺动脉高压组与对照组差异无统计学意义(P>0.05),其他各组之间两两比较,差异均有统计学意义(P<0.05)。PaO_2、第一秒用力呼气容积占预计值的百分比(FEV_1%pred)、第一秒用力呼气量占用力肺活量比值(FEV_1/FVC)随PASP严重程度增高而降低(P<0.05)。RDW与PASP呈显著正相关(r=0.745,P=0.000),RDW与FEV_1%pred、FEV_1/FVC、pH、PaO_2均呈负相关(r=-0.678、-0.696、-0.306、-0.629,P=0.000),其中与pH相关性程度较低。结论 RDW可作为COPD所致肺动脉高压的评估指标之一;酸中毒及低氧血症也可能是导致RDW升高的原因。Objective To explore the relationship between circulating red cell distribution width（RDW） and the pulmonary arterial hypertension in patients with chronic obstructive pulmonary disease.Methods According to the degree of pulmonary artery pressure, patients are divided into normal pulmon artery pressure group（〈35 mmHg, n=56）,mild pulmon artery pressure group（35-50 mmHg, n=47）, moderate pulmon artery pressure group（〉50-70 mmHg, n=50） and severe pulmon artery pressure group（〉70 mmHg, n=45）.Fifty healthy persons served as control group, The RDW and pulmonary function and arterial blood gas analysis were measured and compared.Results The RDW and PaCO2 were increased with the increase of pulmon aryarterial systolic pressure（PASP）（P〈0.05）, but PaCO2 had no difference between control group and normal pulmon artery pressure group.The PaO2, forced expiratory volume in one second to pred（FEV1/pred） and forced vital capacity rate of one second（FEV1/FVC） were decreased of with the increase of PASP（P〈0.05）.The RDW was significantly positive correlated with pulmonary hypertension（r=0.745, P=0.000）.The FEV1%pred, FEV1/FVC, pH, PaO2were negatively correlated with RDW（r=-0.678,-0.696,-0.306,-0.629, P=0.000）.Conclusion RDW can be used as one of the evaluation indicators of decline in lung function in patients with chronic obstructive pulmonary disease, and acidosis and hypoxemia are also the main reasons for the RDW.

关 键 词：肺疾病 慢性阻塞性 高血压 肺性 红细胞分布宽度 

分 类 号：R563.9[医药卫生—呼吸系统]