血红蛋白/红细胞分布宽度比值和红细胞分布宽度/血小板比值在类风湿关节炎病情评估中的应用

目的 探讨类风湿关节炎（RA）患者外周血中血红蛋白/红细胞分布宽度比值（Hb/RDW）和红细胞分布宽度/血小板比值（RPR）与疾病活动度及疗效的关系。方法 回顾性分析102例初诊RA患者(RA组)及与之年龄性别相匹配的103例健康体检者（对照组）的临床资料,计算Hb/RDW和RPR水平并进行比较。分析RA患者Hb/RDW和RPR与疾病活动度的相关性及治疗前后的差异。采用受试者工作特征（ROC）曲线探讨Hb/RDW和RPR对RA的辅助诊断作用。结果 与对照组比较,RA组患者Hb/RDW水平明显降低,RPR水平明显升高（P＜0.05）。随着28个关节疾病活动指数（DAS28）升高,RA患者Hb/RDW及RPR呈降低趋势（P＜0.05）。RA组患者的Hb/RDW与ESR、CRP及DAS28均呈负相关（r=-0.381,r=-0.214,r=-0.319,P均＜0.05）,RPR与ESR、CRP及DAS28呈负相关（r=-0.295,r=-0.282,r=-0.278,P均＜0.05）。规律治疗后的RA患者DAS28较治疗前明显降低,Hb/RDW和RPR较治疗前明显升高（P＜0.05）。ROC曲线分析结果显示,Hb/RDW、RPR诊断RA的ROC曲线下面积分别为0.863（P＜0.001）和0.567（P=0.098）。结论 Hb/RDW可以作为RA疾病诊断的参考指标,Hb/RDW和RPR对RA患者疾病活动度及治疗效果的评估具有重要参考价值。     

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。     

红细胞分布宽度变化在冠心病患者中的临床价值

目的 探讨红细胞分布宽度(RDW)与冠心病的相关性.方法 212例行冠状动脉造影的患者分为两组,以性别、年龄、心率、血压、空腹血糖、总胆固醇(Tc)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL- C)、低密度脂蛋白胆固醇(LDL-C)、红细胞计数、血红蛋白(Hb)、RDW、红细胞压积(Hct)等因素及冠脉评分进行多变...     

Predictive value of neutrophil-to-lymphocyte ratio in diagnosis of early prostate cancer among men who underwent robotic transperineal prostate biopsy

To evaluate the predicted value of neutrophil-to-lymphocyte ratio (NLR) in the diagnosis of early prostate cancer by using standardized Full blood count (FBC) performed within 4 weeks before biopsy and histology results from transperineal prostate biopsy (RTPB).Patients who underwent RTPB under general anesthesia (GA), at Urology Department, Singapore General Hospital between September 2006 and Febuary 2016 were retrospectively reviewed.NLR was calculated using full blood count (FBC) that was done as a pre-admission test before GA within 4 weeks before the biopsy. Statistical analyses were done to establish the correlation of NLR and different clinical parameters such as biopsy histology, pre-biopsy PSA, and prostate volume.A total of 652 patients who underwent RTPB for diagnostic purposes with a valid PSA level were included in this study. There was total of 409 (62.7%) benign histology and 243 (37.3%) prostate cancer. There was no significant difference in median NLR between the benign and prostate cancer group (2.00 vs 1.99; P = .29).In the subgroups analysis, there was also no significant difference of median NLR value in clinical significant cancer (defined as Gleason 3 + 4 and above) and benign histology group (NLR 2.00 vs 2.01, P = .41), as well as prostate cancer and benign group according to different pre-biopsy PSA levels: PSA (ug/l) < 4, 4 to 10, 10 to 20, and >20, respectively. (Median NLR 1.34 vs 1.76; 1.97 vs 1.97; 1.97 vs 2.18; 2.18 vs 1.98, P > .05). NLR is neither associated with prostate cancer using logestic regression model nor a strong predictor of the Gleason grade group and D’Amico risk stratification group using ordinal regression model. (P > .05)There was no statistically significant difference of NLR between the benign and prostate cancer group as a whole or in the subgroup analyses for patients who underwent robotic transperineal prostate biopsy. NLR may have a limited role in predicting early-stage prostate cancer.     

Red cell distribution width to platelet ratio: New and promising prognostic marker in acute pancreatitis

AIM: To evaluate the accuracy of red cell distribution width (RDW) to platelet ratio (RPR) to predict in-hospital mortality in acute pancreatitis (AP).METHODS: Between January 2010 and June 2012, 102 patients with AP were recruited to the study. In this retrospective cohort study, for all subjects, demographic data on hospital admission, AP etiology, co-morbid diseases, organ failure assessment, laboratory parameters and length of hospital stay were examined. Additionally, we used a non-invasive prediction method in addition to the RPR to evaluate the disease severity. Multivariate logistic regression analyses were used to evaluate the impact of RPR on hospital admission to predict mortality.RESULTS: The male-female ratio (59/43) was 1.37 with a median age of 56.5 years (17-89 years). In both univariate and multivariate analyses, RDW and RPR were presented as independent and significant variables on admission to predict mortality. The RPR obtained on hospital admission was persistently higher among non-survivors than among survivors (P < 0.0001). The median RPR was 0.000087 in the non-survivor group and 0.000058 in the survivor group. RPR with a cutoff value of 0.000067 presented an area under the curve of 0.783 (95%CI: 0.688-0.878) in receiver operating characteristic curves and could predict the mortality of approximately 80% of the patients.CONCLUSION: We identified RPR as a valuable, novel laboratory test to predict mortality in AP.     

Practical parameters that can be used for nutritional assessment in patients hospitalized in the intensive care unit with the diagnosis of chronic obstructive pulmonary disease: Prognostic nutritional index,neutrophil-to-lymphocyte,platelet-to-lymphocyte,and lymphocyte-to-monocyte ratio

Malnutrition is an important condition in patients diagnosed with chronic obstructive pulmonary disease (COPD). There is a need for practical and objective nutritional assessment methods in patients hospitalized in the intensive care unit with the diagnosis of COPD. In this study, it was aimed to determine the parameters that can practically evaluate the nutritional status of these patients. It was aimed to determine the relationship between prognostic nutritional index (PNI), and nutritional risk screening (NRS)-2002, nutrition risk in the critical ill (Nutric) Score and to determine a cut-off value for PNI, neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and other complete blood count parameters.Hemogram values, albumin values, NLR, PLR, LMR, NRS-2002, PNI and modified Nutric Score calculations of the patients hospitalized in the intensive care unit due to COPD were recorded. The relationship between PNI and NRS-2002 and modified Nutric Score, as well as the relationship between NLR, PLR, LMR, hemogram parameters and PNI were analyzed using statistical methods.The PNI cut-off value for nutritional assessment in patients hospitalized in the intensive care unit due to COPD was determined as 38.5 (area under curve = 0.891, sensitivity 80.8%, specificity 88.1%, positive predictive value 92.9%, negative predictive value 88%). High-risk group according to PNI compared to low-risk group, lymphocyte count (P < .001), basophil count (P = .004), red blood cell (P < .001), hemoglobin (P < .001), hematocrit (P < .001), and LMR (P = .001) were statistically significantly lower, while NLR (P < .001) and PLR (P = .001) were statistically significantly higher. Cut-off values for lymphocyte count, basophil count, NLR, PLR, and LMR were found to be 1.18, 0.035, 7.97, 291.10, and 2.606, respectively.Nutritional risk assessment can be made in a practical way by using PNI in patients hospitalized in intensive care unit due to COPD. For this, the PNI cut-off value was determined as 38.5 in our study. In addition, NLR, PLR, LMR, basophil and lymphocyte values, which can be calculated using complete blood count parameters, may also be useful in the evaluation of nutritional status in these patients. In our study, the cut-off values determined for NLR, PLR, LMR, basophil and lymphocyte were 7.97, 291.10 and 2.606, 0.035 and 1.18, respectively. We think that the results we have obtained can provide preliminary information for future research.     

Red blood cell distribution width and cardiovascular diseases

Background

The red blood cell distribution width (RDW) is a rather simple measure of red blood cell (RBC) size heterogeneity (i.e., anisocytosis), which is easily calculated by dividing the standard deviation (SD) of erythrocyte volumes for the mean corpuscular volume (MCV). Emerging evidence suggests that, besides RBC abnormalities, many human disorders may be frequently associated with a high degree of anisocytosis.

Methods

In this narrative review, we analyzed the current scientific literature about the putative role and the potential epidemiologic association between RDW and cardiovascular diseases. The findings of the most representative epidemiological studies were summarized and discussed.

Results

Overall, considerable and convincing evidence has been brought that an increased RDW value is associated with acute coronary syndrome (ACS) [including acute myocardial infarction (AMI)], ischemic cerebrovascular disease (including stroke), peripheral artery disease (PAD), as well as with atrial fibrillation (AF), heart failure (HF) and hypertension. Higher anisocytosis also significantly and independently predicts adverse outcomes in patients with these conditions.

Conclusions

Although the role of anisocytosis in the pathogenesis of cardiovascular diseases remains uncertain, the considerable evidence available so far suggests that the clinical use of RDW may be broadened beyond the conventional boundaries of erythrocyte disorders, in particular for assisting the diagnosis and prognostication of patients with ACS, ischemic cerebrovascular disease, PAD, HF and AF.     

Red blood cell distribution width and diabetes-associated complications

AimRed blood cell distribution width (RDW) is a marker of cardiovascular morbidity and mortality. However, there is little data on the relationship between RDW and diabetes-associated complications. The aim was to investigate whether there is any association between RDW, nephropathy, neuropathy and peripheral arterial disease (PAD) in a type 2 diabetic population.MethodsThis study included 196 diabetic patients with proliferative diabetic retinopathy. All subjects were investigated for diabetic nephropathy, diabetic neuropathy and PAD. Participants underwent 24-h blood pressure monitoring and were analysed for markers of the metabolic syndrome, inflammation, and insulin resistance.Results57% of the participants had diabetic nephropathy, 46% had diabetic neuropathy while 26% had PAD. No significant association was found between RDW, diabetic neuropathy and PAD (p = NS). However, RDW was strongly associated with diabetic nephropathy (p = 0.006), even following adjustment for potential confounding variables. Multivariate logistic regression analysis showed RDW (odds ratio [OR] 1.64, 95% confidence interval [CI] 1.15–2.35, p = 0.006), estimated glomerular filtration rate (OR 0.98, 95% CI 0.96–0.99, p < 0.001), night-time diastolic blood pressure (OR 1.07, 95% CI 1.03–1.11, p = 0.001) and erythrocyte sedimentation rate (OR 1.03, 95% CI 1.004–1.05, p = 0.019) to be independently associated with diabetic nephropathy.ConclusionsThis is the first study to report lack of association between RDW, neuropathy and PAD in subjects with type 2 diabetes mellitus. More importantly, RDW was shown to be significantly associated with diabetic nephropathy in a type 2 diabetic population with advanced proliferative retinopathy independent of traditional risk factors, including diabetes duration and glycaemic control.     

Combination of albumin concentration and neutrophil-to-lymphocyte ratio for predicting overall survival of patients with non-small cell lung cancer

BackgroundLung cancer contributes significantly to the total of cancer-linked deaths globally, accounting for 1.3 million deaths each year. Preoperative albumin (Alb) concentration and neutrophil-to-lymphocyte ratio (NLR) may reflect chronic inflammation and be used to predict lung cancer outcomes.MethodsThe clinical records of 293 patients with non-small cell lung cancer (NSCLC) in Fujian Medical University Cancer Hospital & Fujian Cancer Hospital were reviewed retrospectively in this current study. Clinicopathologic pretreatment, including NLR, Glasgow prognostic score (GPS), and post-treatment value, such as tumor-node-metastasis (TNM) were documented. The cut-off finder application was employed to calculate the optimal threshold values. The significance of Alb concentration combined with NLR (COA-NLR) on the prediction of overall survival (OS) was explored using Kaplan-Meier analysis along with Cox proportional hazards.ResultsThe results revealed that COA-NLR could independently assess the OS of patients with NSCLC [hazard ratio (HR) =1.952, 95% confidence interval (CI): 1.367 to 2.647, P<0.001]. Moreover, the 3-year OS rates were 87.2%, 68.5%, and 52.8% for the COA-NLR =0, COA-NLR =1, and COA-NLR =2, respectively (P<0.001).ConclusionsPreoperative COA-NLR value can effectively stratifies prognosis in NSCLC patients by classified patients into three independent groups. It can be adopted as an effective biomarker for prognosis in NSCLC patients treated with resection.     

The predictive value of preoperative serum neutrophil-to-lymphocyte ratio and tumor markers for early breast cancer patients: A retrospective study

Peripheral blood of Neutrophil-to-Lymphocyte ratio (NLR), carcinoma embryonic antigen (CEA), cancer antigen 125 (CA125) and cancer antigen 15–3 (CA15-3) could be used as prognostic indicators for several types of tumors. The purpose of this study was to evaluate the predictive value of inflammatory cell ratio and tumor markers for postoperative breast cancer patients. Clinical data concerning 190 breast cancer patients who underwent radical surgery in Zhejiang Provincial Hospital of Chinese Medicine from 2013 and 2016 were retrospectively analyzed. The effects of NLR, CEA, CA125, and CA153 on the disease-free survival (DFS) of patients with breast cancer were analyzed by χ² test and Cox regression analyses. There were totally 32 of 190 patients had local or distant metastases within 5 years after surgery. The peripheral blood NLR, CEA, CA125, and CA15-3 areas under the curve (AUC) were 0.8272, 0.667, 0.702, and 0.715, and the optimal cutoff values were 2.65, 1.47, 10.55, and 10.55, respectively. Univariate analysis and Kaplan-Meier survival analysis revealed that the serum NLR, CEA, CA125, and CA15-3 were related to postoperative 5-year DFS (P < .05). In addition, multivariate survival analysis identified the following independent prognostic factors: NLR (P < .001), CA125 (P = .045) and ki-67 (P = .020). Preoperative serum inflammatory biomarker of NLR and tumor marker of CA125 have potential prognostic value for breast carcinoma.     

高血压患者血红细胞分布宽度及胱抑素C水平与尿蛋白肌酐比值的关系

目的 观察高血压患者尿微量白蛋白肌酐比值、血清胱抑素C水平及血红细胞分布宽度（RDW）的关系,探讨红细胞分布宽度、胱抑素C水平与高血压早期肾损害的关系。方法 入选高血压患者266例,根据尿微量白蛋白/肌酐比值（UACR）分为高血压肾脏正常组152例（UACR＜30 mg/g）和高血压早期肾损害组114例（UACR≥30 mg/g）,检测患者血脂、空腹血糖、血清胱抑素C、血常规、肌酐（Scr）、尿素氮（BUN）、尿微量白蛋白、尿肌酐,测量体质指数（BMI）,调查有无吸烟、饮酒等危险因素。另设对照组50例（选自我院体检中心健康体检者）。结果 ①与对照组相比,高血压肾脏正常组及高血压早期肾损害组RDW水平均明显升高（13.43±0.92,15.05±1.29 vs 12.09±0.57）,差异有统计学意义（P均<0.01）;高血压早期肾损害组血清胱抑素C水平明显升高（1.46±0.22 vs 1.16±0.18,P<0.01）②与高血压肾脏正常组比较,高血压早期肾损害组RDW水平（15.05±1.29 vs 13.43±0.92）及胱抑素C水平（1.46±0.22 vs 1.20±0.19）均明显升高,差异均有统计学意义（P均<0.01）。③高血压组随着血压水平的升高、UACR的增加,RDW水平逐渐增加。④高血压组RDW与UACR、血清胱抑素C水平、平均收缩压呈正相关（r值分别为0.596、0.633和0.479,P均<0.01）。结论 RDW指标简单易获得,可作为原发性高血压早期肾损害的预测指标,联合血清胱抑素C水平预测价值更高。     

红细胞分布宽度在心血管疾病的临床应用进展

红细胞分布宽度（RDW）是测定血液循环中红细胞体积大小是否具有均一性、形态可变性和大小变异性的一个指标,常结合红细胞平均体积用于诊断贫血。研究表明RDW升高可以在心血管疾病的预测及诊断中提供有价值的线索。本篇综述介绍RDW在心血管疾病中的临床应用。     

红细胞分布宽度和中性粒细胞/淋巴细胞比值评估原发性胆汁性胆管炎患者肝损伤临床价值研究*

目的 探讨应用红细胞分布宽度(RDW)和中性粒细胞/淋巴细胞比值(NLR)评估原发性胆汁性胆管炎(PBC)患者肝损伤的临床价值。方法 2017年3月～2019年12月我院收治的PBC患者93例,其中Ⅰ/Ⅱ期(轻度组)63例,Ⅲ期(重度组)30例。使用血常规分析仪检测血液中性粒细胞和淋巴细胞绝对计数,计算NLR,采用激光电阻抗法检测RDW,应用多元Logistics回归分析影响肝损伤程度的因素,应用ROC曲线分析RDW和NLR评估肝损伤的价值。结果 重度组RDW和NLR显著大于轻度组【分别为(15.8±3.2)%对13.3±2.9)%和(2.1±0.4)对(1.5±0.3),P<0.05】;重度肝损伤组有饮酒史的比率(33.3%对7.9%)、血清GGT水平【(395.3±6.5)U/L对(189.2±6.1)U/L】 、血清ALP水平【(352.1±49.2)U/L对(281.0±46.9)U/L】、RDW≥14.8%的比率(70.0%对46.0%)和NLR≥1.8的比率(76.7%对41.3%)显著高于轻度肝损伤组(所有P<0.05);多因素分析显示,有饮酒史【OR(95%CI)为1.8(1.1～2.9)】、GGT≥293.1 U/L【OR(95%CI)为1.7(1.2～2.5)】、ALP≥327.6 U/L【OR(95%CI)为1.9(1.2～2.8)】、RDW≥14.8%【OR(95%CI)为1.9(1.2～2.8)】和NLR≥1.8【OR(95%CI)为1.7(1.3～2.2)】是严重肝损伤的独立危险因素;分别以RDW=14.8%和NLR=1.8为截断点,其联合诊断严重肝损伤的AUC为0.854,其灵敏度为86.7%,显著高于两指标中任一指标的评估,而特异性为71.4%,稍低于两指标的单一评判。结论 应用NLR评估PBC患者肝损伤程度具有一定的临床价值,其简单、易得,联合RDW可提高灵敏度,但特异性较差,两者联合应用的价值需要进一步探讨。     

Prognostic value of red blood cell distribution width in patients with acute pulmonary embolism: A protocol for systematic review and meta-analysis

Background:Prior reports have suggested that the red blood cell distribution width (RDW) parameter could be measured as a prognostic indicator in pulmonary embolism (PE) patients, thereby helping to guide their care. However, no systematic analyses on this topic have been completed to date, and the exact relationship between RDW and PE remains to be fully clarified. We will therefore conduct a systematic literature review with the goal of defining the correlation between RDW and mortality in acute PE cases.Methods:The EMBASE, Web of Knowledge, PubMed, ClinicalTrials.gov, and Cochrane Library databases will be searched for all relevant studies published from inception through March 2021 using the following search strategy: (“red blood cell distribution width”) AND (“pulmonary embolism”). Two authors will independently identify eligible studies and extract data. The Q and I² statistics will be used to judge heterogeneity among studies.Results:This study will establish the relative efficacy of RDW as a metric for predicting PE patient mortality.Conclusions:This study will offer a reliable, evidence-based foundation for the clinical utilization of RDW as a tool for gauging mortality risk in acute PE patients.Ethics and dissemination:As this is a protocol for a systematic review of previously published data, no ethical approval is required. Electronic dissemination of study results will be done through a peer-review publication or represented at a related conference.     

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。