红细胞分布宽度、平均血小板体积与早发冠心病的相关性

目的探讨红细胞分布宽度(RDW)、平均血小板体积(MPV)在早发冠心病人群中的分布特征及其与冠状动脉病变严重程度的关系,评价RDW、MPV对早发冠心病的诊断价值。方法收集因胸痛发作疑诊冠心病且男性55岁、女性65岁的患者407例,经冠状动脉造影(CAG)确诊早发冠心病组309例,余98例为正常对照组。比较2组及早发冠心病各疾病亚组间的RDW、MPV水平,分析RDW、MPV与冠状动脉病变严重程度(Gensini评分)的相关性及早发冠心病的独立危险因素。结果早发冠心病组RDW、MPV水平明显高于正常对照组(P0.05),RDW、MPV在急性心肌梗死(AMI)组、不稳定型心绞痛(UAP)组和稳定型心绞痛(SAP)组均高于正常对照组(P0.05)。早发冠心病组RDW、MPV与Gensini评分之间存在正相关(r分别为0.246、0.199,P0.05);多因素Logistic回归分析显示RDW(OR=3.373,95%CI:2.197～6.359,P0.001)和MPV(OR=1.353,95%CI:1.074～1.705,P=0.010)是早发冠心病的独立危险因素。R0C曲线分析发现,RDW诊断早发冠心病的界点值为12.25%(敏感性69%,特异性72%),MPV诊断早发冠心病的界点值为8.55 fl(敏感性91%,特异性37%)。结论 RDW、MPV与早发冠心病的临床类型及冠状动脉病变的严重程度有关,是早发冠心病的独立危险因素,为早发冠心病的诊断提供一定依据。     

Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia

We investigated the significance of the platelet indices, mean platelet volume (MPV), platelet size deviation width (PDW), and platelet-large cell ratio (P-LCR), in the diagnosis of thrombocytopenia by comparing these levels in 40 patients with hypo-productive thrombocytopenia (aplastic anaemia; AA) and 39 patients with hyper-destructive thrombocytopenia (immune thrombo-cytopenia; ITP). The sensitivity and specificity of platelet indices to make a diagnosis of ITP were also compared. All platelet indices were significantly higher in ITP than in AA, and platelet indices showed sufficient sensitivity and specificity. The area under the curve (AUC) of the receiver operating characteristics curve of platelet indices was large enough to enable the diagnosis of ITP. P-LCR and PDW had the largest AUCs, which indicated that these values were very reliable for immune thrombocytopenia. Our results suggest that these indices provide clinical information about the underlying conditions of thrombocytopenia. More attention should be paid to these indices in the diagnosis of thrombocytopenia.     

A prognostic nomogram incorporating red cell distribution width for patients with intracerebral hemorrhage

Intracerebral hemorrhage (ICH) is the second most common subtype of stroke with higher mortality and morbidity, and it lacks effective prognostic markers. The aim of this research is to construct newly valuable prognostic nomogram incorporating red blood cell distribution width (RDW) for ICH patients.We retrospectively analyzed 953 adult patients with ICH. The impacts of RDW on short-term mortality and functional prognosis were calculated using Akaike information criterion (AIC), Bayesian information criteria (BIC) and the area under the curve (AUC) respectively, which could be used to compare with Glasgow coma scale (GCS) and ICH score. The independent factors of prognosis were identified by univariate and multivariate logistic regression analysis. A nomogram based on RDW for nerve functional prognosis was further constructed and validated. Its clinical value was subsequently explored utilizing decision curve analysis.Cumulative clinical results were retrieved for 235 inpatients from Jan 2012 to June 2017. In 30-day mortality sets, GCS and ICH score had better prognostic performance than RDW (AUC: 0.929 and 0.917 vs 0.764; AIC: 124.101 and 134.188 vs 221.372; BIC: 131.021 and 141.107 vs 228.291). In 30-day functional prognosis sets, the consequences of evaluation systems were inconsistent. GCS was the best parameter for predicting outcome using AIC (262.350 vs 276.392 and 264.756) and BIC (269.269 vs 283.311 and 271.675). However, RDW was higher than GCS and ICH score considering AUC (0.784 vs 0.759 and 0.722). Age, GCS, RDW, platelet distribution width, and surgery were independent prognostic factors by multivariate logistic regression analysis, and those coefficients were used to formulate a nomogram. This nomogram can provide accurate prediction with the concordance index of 0.880 (95% CI, 0.837–0.922) higher than Harrell''s concordance index of GCS system 0.759 (95% CI, 0.698–0.819) and RDW 0.784 (95% CI, 0.721–0.847). The calibration plots showed optimal consistency between bootstrap-predicted and the actual observed values of 30-day unfavorable prognosis. Decision curve analysis showed an increased net benefit for utilizing the nomogram.High RDW values are associated with an unfavorable outcome after ICH. The established nomogram incorporating RDW should be considered for a 30-day functional prognosis.     

原发性高血压患者尿微量白蛋白、超敏C反应蛋白、红细胞体积分布宽度间关系及临床意义

目的探讨原发性高血压患者尿微量白蛋白(MAU)、超敏C反应蛋白(hs-CRP)、红细胞体积分布宽度(RDW)间关系及MAU危险因素。方法选择原发性高血压患者111例,按血压分级分为3组,高血压1级组14例,2级组42例,3级组55例。检测患者三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、hs-CRP、RDW、MAU、肌酐(Scr)、尿素氮(BUN)、糖化血红蛋白(HbAlc)、腰臀比(WHR)、体质量指数(BMI),询问高血压病程,调查有无吸烟、饮酒、糖尿病、冠心病病史等危险因素。结果 3组比较,年龄、TC、TG、LDL-C、HDL-C、高血压病程、Scr、BUN、HbAlc、WHR、BMI、性别、吸烟、饮酒、糖尿病、冠心病病史差异均无统计学意义;而3组间MAU、hs-CRP、RDW差异均有统计学意义,高血压3级组较1级、2级组明显升高[MAU:高血压1级组:(6.00±4.87)mg/24h,2级组:(7.37±5.86)mg/24h,3级组:(10.80±7.24)mg/24h;hs-CRP:高血压1级组:(1.11±0.48)mg/L,2级组:(0.90±0.35)mg/L,3级组:(1.49±0.79)mg/L;RDW:高血压1级组:(12.09±0.57)CV%,2级组:(12.20±0.69)CV%,3级组:(12.51±0.47)CV%,均为P0.05];hs-CRP与MAU、RDW均呈正相关(r=0.336,P=0.002;r=0.269,P=0.042),MAU与RDW亦呈正相关(r=0.278,P=0.044);Logistic多元回归分析显示,Scr(OR=1.131,P=0.032)、hs-CRP(OR=4.752,P=0.048)、RDW(OR=9.888,P=0.028)、糖尿病(OR=29.398,P=0.009)进入回归方程,是MAU的独立危险因素。结论原发性高血压患者MAU、hs-CRP、RDW互为相关,血Scr、hs-CRP、RDW和糖尿病是高血压患者MAU的独立危险因素。MAU用于评估高血压患者发生肾脏并发症的危险程度及其治疗效果具有重要意义。     

红细胞分布宽度与血小板计数比值对老年脓毒症患者临床转归的预测价值

目的 探讨红细胞分布宽度(RDW)与血小板计数(PLT)的比值(RPR)与老年脓毒症患者严重程度和预后的相关性.方法 回顾性分析2019年1月至2020年6月东部战区总医院(原南京军区南京总医院)收治的174例老年脓毒症患者的临床资料,采集患者一般人口学、实验室和辅助检查结果及临床转归等资料,计算诊断脓毒症后3 d内最...     

The mean red cell volume in diabetes mellitus

Summary The Coulter mean red cell volume was found to be significantly elevated in a sample of 100 diabetic patients compared with 200 normal subjects (p < 0.01). There was no correlation between the mean red cell volume level and the type of diabetes, its method of treatment or degree of control as measured by random blood glucose and glycosylated haemoglobin levels.     

Red cell distribution width and mean platelet volume in rheumatoid arthritis patients: Its association with disease activity

IntroductionHemogram parameters have been recently proposed as markers of inflammation in various studies from different parts of the world. Two of these hemogram parameters are red cell distribution width (RDW) and mean platelet volume (MPV).AimTo evaluate the relation between RDW and MPV with disease activity of rheumatoid arthritis. To assess whether RDW and MPV can be used to follow disease activity in RA patients.MethodsThis is an observational cross-sectional study that was carried out on 60 rheumatoid arthritis patients who fulfilled the ACR/EULAR2010 classification criteria of RA attending to Rheumatology and Rehabilitation inpatient and outpatient clinics at Zagazig University Hospitals. All cases were subjected to full history taking, clinical examination, and laboratory investigations; differential complete blood picture (CBC), acute phase reactants (CRP and ESR), rheumatoid factor (RF) and anti-cyclic-citrullinated peptide (anti-CCP) antibodies. Disease activity was measured by disease activity score 28 (DAS28).ResultsThe cut-off levels of RDW and MPV were 14.85 and 11.25. Patients with RDW > 14.85 had higher Disease Activity Score 28 (DAS28; p = 0.0003), ESR (p = 0.0001) and CRP (p = 0.0001). RDW was positively correlated with disease activity markers (ESR, CRP and DAS28) in rheumatoid arthritis patients. But, DAS28 was not different between patients with MPV > 11.25 and <11.25.ConclusionRDW was strongly correlated with disease activity. Also, RDW was better than ESR and CRP in detecting RA disease activity. According to these findings we suggest that RDW can be used in clinics to follow disease activity. In addition, RDW is widely available; as it's usually included in routine complete blood picture and there will be no need for further cost.     

Increased red cell distribution width and coeliac disease

BACKGROUND/AIMS: Despite availability of sensitive screening tests, coeliac disease is still underdiagnosed. To determine which haematochemical abnormalities might be more predictive of this condition, we reviewed the clinical records of our series of adult patients affected by coeliac disease. METHODS: Six haematochemical parameters (haemoglobin, red cell distribution width, serum levels of iron, albumin, calcium and potassium) were evaluated in 126 consecutive adult untreated coeliac patients diagnosed since 1990. RESULTS: Elevated red cell distribution width was the most frequent haematochemical abnormality, being present in 57.9% of our patients (Chi square analysis, p<0.01 versus other laboratory changes). CONCLUSION: The increase of red cell distribution width was more common than iron-deficiency anaemia, a well-known indicator of coeliac disease. Elevated red cell distribution width can thus be considered a new predictor of coeliac disease and in the presence of this a search should be made for antiendomysial antibodies.     

The relationship between mean platelet volume with microalbuminuria and glycemic control in patients with type II diabetes mellitus

Microalbuminuria is the best predictor of diabetic nephropathy development in patients with type II diabetes mellitus (DM). It is also accepted as an indicator of diabetic microangiopathy. Increased activation of platelets has been suggested to be involved in the pathogenesis of vascular complications. In light of these findings, this study was designed to investigate the association of microalbuminuria — an indicator glycemic control and microangiopathy — with mean platelet volume (MPV). Subjects underwent laboratory analyses and their MPV, HbA1c, serum creatinine, fasting, and postprandial blood glucose levels and 24-hour urine albumin levels were recorded. All statistical analyses were performed using SPSS v13.0 for Windows XP. Mann–Whitney U-test, student's t-test, spearman correlation analysis, ROC analysis, categorical regression analysis, and chi-square test were used for statistical evaluations. The study included 354 patients with type II DM. The median MPV value of microalbuminuria-positive patients was 9 (8–9.5)?fl while MPV of patients without microalbuminuria was 8.5 (8–9.2)?fl and the difference was statistically significant (p?=?0.004). We determined positive correlation between MPV and 24-hour urine microalbuminuria (r?=?0.14, p?=?0.009). There were no significant differences between patients with HbA1c levels below and above 7% in terms of MPV (p?>?0.05). We determined no correlation between MPV and HbA1c levels (r?=??0.36, p?=?0.64). This study determined a significant positive relationship between microalbuminuria — a microvascular complication of diabetes — and MPV. No significant correlation was identified between poor glycemic control and MPV in diabetic patients. However, we are in the opinion that the association between poor glycemic control and MPV in type II diabetic patients should be investigated in prospective studies with larger samples.     

红细胞分布宽度在急性冠脉综合征患者非罪犯病变斑块进展中的预测作用

目的评估红细胞分布宽度(RDW)等指标在预测急性冠脉综合征(ACS)患者非罪犯病变斑块进展中的价值方法入选2008年8月1日至2013年8月1日住解放军总医院心脏介入中心行经皮冠状动脉介入治疗(PCI)术的ACS患者421例。根据三维定量冠状动脉造影(3D-QCA)分析斑块进展与否,将所有患者分为两组:进展组(n=109)和非进展组(n=312)。比较两组患者相关临床资料、传统危险因素的差异,并通过logistic回归分析探讨RDW和其他危险因素与非罪犯斑块进展之间的关系。结果与非进展组相比,进展组患者RDW显著增高[(13.08±0.73)%vs(12.89±0.71)%,P=0.020]。RDW四分位分组分析斑块进展结果也表明,随RDW的升高,非罪犯病变血管斑块进展在各组中听占的比例也呈升高趋势,且两两比较差异均具有统计学意义(P0.05)。经校正后的多因素回归分析显示RDW(OR=1.385,P=0.045)和糖尿病(OR=1.809.P=0.026)是病变进展的独立危险因素。结论 RDW能够在一定程度上预测ACS患者非罪犯病变斑块的进展。     

红细胞分布宽度和冠心病的关系

红细胞分布宽度（RDW）与炎症、冠状动脉病变的严重程度、冠状动脉的不稳定性有一定的相关性,能够预测冠心病（CHD）的预后。RDW的检测可能成为一种经济、简便易行用于CHD危险分层的方法。     

红细胞体积分布宽度与慢性心力衰竭心功能指标关系的研究

目的:研究慢性心力衰竭(CHF)患者红细胞体积分布宽度(RDW)水平与心脏超声心功能指标的关系及临床意义。方法:选取2009-03-2010-03于辽宁医学院附属第一医院心内科住院治疗临床诊断为CHF的176例作为实验组,按照纽约心脏学会(NYHA)分级将其分为NYHAⅠ级31例、NYHAⅡ级39例、NAⅢ级52例、NYHAⅣ级54例。选取门诊健康体检者36例作为对照组。测量其RDW及左室舒张末期内径(LVEDD)、左室射血分数(LVEF)。比较各组的RDW值;利用相关分析研究RDW与LVEDD、LVEF的关系。结果:CHF组RDW高于对照组,差异有统计学意义(P<0.01);CHF组内随着NYHA级别的增高,RDW逐渐升高,各组间两两比较差异均有统计学意义(P<0.05);RDW与LVEDD呈正相关(r=0.759,P<0.01),与LVEF呈负相关(r=-0.743,P<0.01)。结论:RDW是反映心功能受损的敏感指标,与心功能状态和左室重塑有明显的相关性,RDW的检测可对不同程度的CHF患者进行评估,对指导CHF治疗、评价预后均具有重要临床价值。     

The association of red cell distribution width with in-stent restenosis in patients with stable coronary artery disease

Increased red cell distribution width (RDW) is closely related to the poor prognosis and adverse events of cardiovascular diseases. We aimed to investigate the association of serum RDW levels and in-stent restenosis (ISR) after coronary stenting with bare-metal stent in patients with stable coronary artery disease. A total of 251 patients (age 62?±?11 years, 69% male) with a history of coronary stenting who underwent control coronary angiography (128 with ISR and 123 without ISR) were enrolled into the study. Laboratory parameters were measured before angiography. ISR was defined as luminal stenosis ≥50% within the stent or within 5?mm of its edges by the quantitative coronary analysis. The patients were divided into the two groups: ISR group and no-ISR group. Baseline characteristics of the patients were similar. The ISR group had significantly higher RDW levels compared with patients in no-ISR group (14.47?±?1.37 vs. 13.59?±?0.88, p?<?0.001). Furthermore, the ISR group had significantly longer stent length and lower stent diameter when compared to no-ISR group (p?=?0.001 and p?=?0.004, respectively). In a multivariate analysis, RDW levels >13.75%, high-sensitivity C-reactive protein levels, stent diameter and stent length were independently associated with ISR [odds ratio (OR)?=?2.12, 95% confidence interval (CI)?=?1.71–3.15, OR?=?2.80, 95% CI?=?(1.34–4.61), OR?=??2.60, 95% CI?=??(1.19–4.51), OR?=?2.02, 95% CI?=?1.99–3.76, p?=?0.001, respectively]. We concluded that increased serum RDW levels were independently associated with bare-metal ISR in patients with stable coronary artery disease.     

Atrial fibrillation is associated with increased mean platelet volume in patients with type 2 diabetes mellitus

Platelet abnormalities in diabetes mellitus (DM) and atrial fibrillation (AF) may underline the etiology of a prothrombotic state in these conditions. Increased mean platelet volume (MPV) is a marker of abnormal platelet function and activation. We aimed to investigate the possible association of chronic AF with MPV in patients who have type 2 DM. Patients who had type 2 DM with either chronic (≥6 months) AF or normal sinus rhythm (NSR) were included in the study. A total of 162 patients (aged 38–89 years) were divided into 2 groups according to the presence of either AF or NSR. Group 1 consisted of 81 diabetic patients with AF, and group 2 consisted of 81 diabetic patients with NSR. The two groups were not significantly different in terms of age, and gender, as well as in hypertension, smoking, history of coronary artery disease, previous cerebrovascular accidents, microalbuminuria, retinopathy, duration of DM, body mass index, hemoglobin A_1c, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride (p?>?0.05 for all variables). Although no significant difference was present between groups concerning platelet count; for patients with AF, MPV was higher compared with patients with NSR (9.0?±?0.2?fl vs. 8.4?±?0.2?fl; p?=?0.001). Furthermore, no significant difference was noted between groups regarding routine medications received by patients. In multivariate logistic regression analysis, MPV was the only variable independently related to AF (OR?=?2.659; 95% CI, 1.286–5.498; p?=?0.008). Consequently, it is concluded that AF is associated with increased MPV in patients with type 2 DM, suggesting the presence of tentatively related processes leading to reciprocal interaction.     

红细胞分布宽度在肺部疾病中的临床价值

红细胞分布宽度(red cell distribution width,RDW)可反映外周血红细胞大小不一的程度,是评价红细胞异质性的参数,临床上常用于贫血的诊断和鉴别诊断。近年来,RDW 在评估肺部疾病严重程度和预后中的作用逐步得到了人们的重视。研究证实,RDW 的变化可能是整体上反映与患者病情和预后密切相关的因素,从而在提示肺部疾病的病变程度和远期预后中发挥重要作用。