子宫腺肌病患者外周血红细胞分布宽度水平检测的临床诊断价值研究  

Clinical Diagnostic Value of Red Blood Cell Distribution Width in Peripheral Blood of Adenomyosis Patients

作　　者：张玲玲 张雪花[1] 张苑艳 周晖登[1] ZHANG Lingling;ZHANG Xuehua;ZHANG Yuanyan;ZHOU Huideng(the Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530002,China)

机构地区：[1]广西壮族自治区妇幼保健院,南宁530002

出　　处：《现代检验医学杂志》2024年第3期189-193,共5页Journal of Modern Laboratory Medicine

基　　金：广西自筹经费科研课题(Z20210374);广西临床重点专科(医学检验)建设项目。

摘　　要：目的探讨子宫腺肌病患者外周血红细胞分布宽度(red blood cell distribution width,RDW)的变化及临床意义。方法对2020年1月~2022年12月于广西壮族自治区妇幼保健院收治的300例子宫腺肌病患者和250例健康体检者进行回顾性研究。Mann-Whitney U检验用于比较患者组(包括治疗前与治疗后)和健康对照组的血细胞检测参数水平。采用Spearman相关分析评估RDW与其他血液炎性参数的相关性;采用ROC评估RDW在子宫腺肌病中的诊断效能。此外,Logistic多因素分析子宫腺肌病的独立危险因素。结果与健康对照组相比,子宫腺肌病患者的RDW水平[14.60%(13.20%~18.65%)vs 13.00%(12.40%~13.80)%]升高,差异具有统计学意义(Z=11.396,P=0.001),治疗后患者的RDW水平[14.10%(12.10%~15.90%)vs 14.60%(13.20%~18.65%)]降低,差异具有统计学意义(Z=8.339,P=0.001)。相关分析结果显示,RDW与血红蛋白、红细胞压积、平均红细胞体积和绝对淋巴细胞计数呈负相关(r=-0.709,-0.614,-0.801,-0.131,均P<0.05),但与红细胞、血小板和血小板淋巴细胞比率呈正相关(r=0.184,0.439,0.406,均P<0.05)。ROC曲线分析显示,RDW诊断子宫腺肌症的敏感度和特异度分别为63.0%,97.6%,曲线下面积为0.782,95%可信区间为0.745~0.819。Logistic回归分析显示,RDW和CA125是子宫腺肌病发生的独立危险因素(均P<0.05)。结论子宫腺肌病患者的RDW升高,提示RDW是子宫腺肌病的潜在辅助诊断指标。Objective To investigate the changes and clinical significance of red blood cell distribution width(RDW)in peripheral blood of patients with adenomyosis.Methods A retrospective study was performed on 300 adenomyosis patients and 250 age-matched individuals who were admitted to the Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region from January 2020 to December 2022.Mann-Whitney U test was used to compare blood parameters between the patient group(including before and after treatment)and the healthy control group.The diagnostic efficacy of RDW in adenomyosis was evaluated by ROC.Spearman correlation method was used to analyze RDW’s association with other blood inflammatory parameters.Logistic multivariate analysis was applied to analyze the independent risk factors for adenomyosis.Results Compared with healthy control group,RDW values were in patients with adenomyosis[14.60%(13.20%~18.65%)vs 13.00%(12.40%~13.80)%],and the difference was statistically significant(Z=11.396,P=0.001).In addition,the RDW levels of patients after treatment were reduced compared with healthy control group[14.10%(12.10%~15.90%)vs 14.60%(13.20%~18.65%)],and the difference was statistically significant(Z=8.339,P=0.001).Correlation analysis results showed that RDW was negatively correlated with hemoglobin,hematocrit,mean corpuscular volume and absolute lymphocyte count(r=-0.709,-0.614,-0.801,-0.131,all P<0.05),but positively correlated with red blood cell,platelet and platelet lymphocyte ratio(r=0.184,0.439,0.406,all P<0.05).ROC curve analysis showed that the sensitivity and specificity of RDW for diagnosing adenomyosis were 63.0%and 97.6%,the area under the curve was 0.782,95%confidence interval was 0.745~0.819,respectively.Logistic regression analysis showed that RDW was independently associated with adenomyosis(OR=0.755,95%CI=0.677~1.347,P=0.012).Conclusion RDW was elevated in patients with adenomyosis,suggesting that RDW may be a potential auxiliary diagnostic marker for adenomyosis.

关 键 词：子宫腺肌病 红细胞分布宽度 

分 类 号：R711.74[医药卫生—妇产科学] R446.111[医药卫生—临床医学]