红细胞分布宽度对克罗恩病活动性的诊断价值  

Diagnostic value of red blood cell distribution width for the activity of Crohn′s disease

作　　者：薛娇洁[1,2] 张敏 张艺韬 欧阳茂[1,2] 陈志冲 程诗尧 曾伟杰[1,2] Xue Jiaojie;Zhang Min;Zhang Yitao;Ouyang Mao;Chen Zhichong;Cheng Shiyao;Zeng Weijie(Department of Cardiology,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Biomedical Innovation Center,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510000,China;Department of Gastroenterology,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院心血管内科,广州510655 [2]广州市黄埔区中六生物医学创新研究院,广州510000 [3]中山大学附属第六医院消化内科,广州510655

出　　处：《中华炎性肠病杂志（中英文）》2023年第4期324-330,共7页Chinese Journal of Inflammatory Bowel Diseases

基　　金：中山大学附属第六医院临床医学研究1010计划(1010PY(2023)-17);广东省消化系统疾病临床医学研究中心(2020B1111170004);中山大学青年教师培育项目(19ykpy10)。

摘　　要：目的研究红细胞分布宽度(RDW)与克罗恩病(CD)疾病活动性的关系,探讨RDW对CD活动性的诊断价值。方法采用横断面研究方法,收集2012年11月至2014年10月中山大学附属第六医院连续收治的CD患者(CD组)的临床资料,其中包括入院后第1次的常规血液学检查结果和C-反应蛋白(CRP)水平。将同期健康体检者作为正常对照组,收集其常规血液学检查结果。根据CD疾病活动指数(CDAI)将CD患者分为缓解组、轻度活动组、中重度活动组。比较CD组与正常对照组以及CD患者各亚组间RDW和血小板淋巴细胞比值(PLR)等常规血液学检查指标差异,并行RDW、PLR与CD活动性或CRP的相关性分析,采用ROC曲线确定RDW对CD疾病活动性的诊断价值。行Logistic单因素和多因素回归分析CD疾病活动性的独立影响因素,同时构建Logistic回归方程,计算影响因素的诊断效能。结果CD组共纳入303例CD患者,男性216例,女性87例;年龄(28.6±11.7)岁。正常对照组293例,男性190例,女性103例;年龄(30.1±12.3)岁。两组年龄及性别差异均无统计学意义(均P>0.05),具有可比性。CD患者中,缓解组10^(9)例,轻度活动组106例,中重度活动组88例;3个亚组年龄及性别的差异均无统计学意义(均P>0.05),具有可比性。CD组的RDW(15.26%±2.51%比13.10%±1.13%,P<0.001)、PLR(245.09±158.69比119.07±36.52,P<0.001)、中性粒细胞淋巴细胞比值(NLR)[3.22(2.06,4.75)比1.76(1.39,2.32),P<0.001]、白细胞计数[(7.68±3.30)×10^(9)/L比(6.52±1.68)×10^(9)/L,P<0.001]、血小板计数[(320.69±116.10)×10^(12)/L比(230.10±51.08)×10^(12)/L,P<0.001]均高于正常对照组,而血红蛋白[(112.8±21.0)g/L比(137.1±13.5)g/L,P<0.001]及血小板分布宽度(PDW)[(10.70±1.91)fl比(11.89±1.75)fl,P<0.001]均显著低于正常对照组,差异均具有统计学意义。与缓解组患者比较,轻度活动组CD患者RDW和血小板计数更高,血红蛋白更低,差异均具有统计学意义(均P<0.05)。与缓解组和Objective To investigate the relationship between red blood cell distribution width(RDW)and activity of Crohn′s disease(CD),and explore the diagnostic value of RDW for CD activity.Methods A cross-sectional study was conducted.Clinical data of CD patients treated continuously at the Sixth Affiliated Hospital of Sun Yat-sen University from November 2012 to October 2014(CD group)were collected,including the first results of routine hematological examinations and C-reactive protein(CRP)levels after admission.Routine hematological examination results were also collected from healthy peoples undergoing regular health check-ups at the same time,who served as the normal control group.CD patients were divided into remission,mild activity,and moderate-severe activity groups based on the Crohn′s disease activity index(CDAI).The levels of routine hematological indicators including RDW and platelet-to-lymphocyte ratio(PLR)were compared between the CD group and the normal control group,as well as among different subgroups of CD patients.The correlations between RDW,PLR and CD activity or CRP were analyzed,and the diagnostic value of RDW for CD activity was evaluated by using ROC curve.Logistic univariate and multivariate regressions were performed to analyze the influencing factors of the activity of CD.Logistic regression equation was constructed to calculate the diagnostic efficacy of the influencing factors.Results A total of 303 CD patients(216 males,87 females;mean age 28.6±11.7 years)were assigned to CD group and 293 healthy peoples(190 males,103 females;mean age 30.1±12.3 years)were assigned to normal control group.There was no significant differences in age and gender between the two groups(both P>0.05),indicating comparability.Among the CD patients,10^(9) were in remission group,106 in mild activity group,and 88 in moderate-severe activity group.There was no significant differences in age and gender among the three subgroups(all P>0.05),indicating comparability.Compared with the normal control group,RDW(15.26%±

关 键 词：克罗恩病 红细胞分布宽度 活动性 诊断价值 

分 类 号：R574.62[医药卫生—消化系统]