红细胞平均体积及其分布宽度值鉴别贫血的初步研究

目的　研究用红细胞平均体积 (MCV)及红细胞体积分布宽度 (RDW )鉴别各型贫血 ,以期改进传统的贫血形态学分类方法。方法　选取患者组 2 32例及对照组 12 0例行MCV及RDW测定 ,统计出各病例组及对照组的MCV、RDW值 ,结合临床进行分析。结果　不同贫血时 ,其外周血红细胞的MCV及RDW的改变各具特征。结论　MCV、RDW诊断各类型贫血的敏感性及特异性较高 ,对贫血的鉴别诊断有较为广泛的临床应用价值。     

Prevalence and predictors associated with severe pulmonary hypertension in COPD

Background

Pulmonary hypertension (PH) is one of the most common complications of COPD (chronic obstructive pulmonary disease), but its severe form is uncommon. Various factors play an important role in the occurrence and severity of pulmonary hypertension in patients.

Toxicology of 3-epi-deoxynivalenol,a deoxynivalenol-transformation product by Devosia mutans 17-2-E-8

Microbial detoxification of deoxynivalenol (DON) represents a new approach to treating DON-contaminated grains. A bacterium Devosia mutans 17-2-E-8 was capable of completely transforming DON into a major product 3-epi-DON and a minor product 3-keto-DON. Evaluation of toxicities of these DON-transformation products is an important part of hazard characterization prior to commercialization of the biotransformation application. Cytotoxicities of the products were demonstrated by two assays: a MTT bioassay assessing cell viability and a BrdU assay assessing DNA synthesis. Compared with DON, the IC₅₀ values of 3-epi-DON and 3-keto-DON were respectively 357 and 3.03 times higher in the MTT bioassay, and were respectively 1181 and 4.54 times higher in the BrdU bioassay. Toxicological effects of 14-day oral exposure of the B6C3F₁ mouse to DON and 3-epi-DON were also investigated. Overall, there were no differences between the control (free of toxin) and the 25 mg/kg bw/day or 100 mg/kg bw/day 3-epi-DON treatments in body and organ weights, hematology and organ histopathology. However, in mice exposed to DON (2 mg/kg bw/day), white blood cell numbers and serum immunoglobulin levels were altered relative to controls, and lesions were observed in adrenals, thymus, stomach, spleen and colon. Taken together, in vitro and in vivo studies indicate that 3-epi-DON is substantially less toxic than DON.     

Reticulocyte Hemoglobin Equivalent (Ret-He) Combined with Red Blood Cell Distribution Width Has a Differentially Diagnostic Value for Thalassemias

Abstract

As a type of congenital microcytic hypochromic anemia, thalassemia trait is often confused with other conditions, such as congenital sideroblastic anemia (CSA) and iron deficiency anemia, before a specific work-up is performed. However, these tests, including hemoglobin (Hb) electrophoresis, gene mutations and Prussian blue staining after bone marrow aspirate, are relatively expensive, time-consuming and invasive. To find labor-saving parameters to facilitate differential diagnosis, we retrospectively analyzed the routine blood indexes of 59 thalassemia trait cases [22 α-thalassemia (α-thal), 36 β-thalassemia (β-thal) and one α/β-thal], 21 CSA patients, and 238 iron deficiency anemia controls. Significantly higher reticulocyte Hb equivalent (Ret-He) and lower red blood cell (RBC) distribution width (RDW) were prominent in thalassemia trait. Furthermore, RDW-standard deviation (SD) was independent of the severity of anemia in thalassemia trait, similar to Ret-He in CSA. In the context of the same grades of anemia, Ret-He combined with RDW was powerful in differentiation of thalassemia from CSA and iron deficiency anemia. By receiver operation curve (ROC) analysis, Ret-He had a specificity of 67.06% and a sensitivity of 76.92% with a cutoff value of 20.9?pg for thalassemia trait in mild anemia and a specificity of 84.09% and a sensitivity of 68.42% with a cutoff value of 19.1?pg for thalassemia trait in moderate anemia. Regarding CSA, Ret-He had 92.94% specificity and 60.00% sensitivity in mild anemia, with a cutoff value of 18.1?pg. Overall, Ret-He and RDW are two convenient indexes able to differentiate thalassemia from the other two microcytic anemias, CSA and iron deficiency anemia.     

红细胞分布宽度和左心房容积指数与非瓣膜性心房颤动的关系

【摘要】目的：探讨红细胞分布宽度(RDW)和左心房容积(LAV)指数(LAVI)与心房颤动（AF）间的关系,筛选早期预测AF的指标。方法：108例非瓣膜性阵发性AF的患者为AF组和84例无AF患者为对照组,两组均进行体格检查和超声心动图影像学检查,全血细胞计数分析了RBC、RDW、中性粒细胞、中性粒细胞/淋巴细胞比值（NLR）及平均红细胞体积。比较两组人口学资料和超声心动图的资料。结果：AF组LAV、LAVI、RDW和hs-CRP均显著高于对照组(P＜0.05)。两组NLR比较无明显差异(P＞0.05)。多元Logistic回归分析显示：升高的LAVI、RDW和hs-CRP是非瓣膜性AF发生的独立预测因子。结论：升高的RDW水平和升高的LAVI可能是独立的非瓣膜性AF发生的预测危险因素。     

Red Blood Cell Distribution Width (RDW) and long-term survival in patients with ST Elevation Myocardial Infarction

Introduction

High RDW values are associated with adverse prognosis in many clinical conditions including short and medium term outcome of patients with ST Elevation Myocardial Infarction (STEMI). The aim of the present study was to evaluate the association between RDW and long term mortality in STEMI patients undergoing primary angioplasty (PPCI).

Material and methods

A cohort of 535 STEMI patients undergoing PPCI were divided into two groups (RDW > 14%, RDW ≤ 14%) using CHAID and CART methods. The association between RDW and 5-year all-cause mortality was assessed using Cox’s proportional hazards analysis.

Results

A total of 37 patients died during follow up of 5 years (mean: 1059, median: 1013, range 2–2130 days). RDW > 14% was associated with increased risk of all-cause mortality (HR = 5, CI 95% 2.7– 9.9, p < 0.001). In multivariate analysis, RDW > 14 remained significantly associated with increased risk for all-cause mortality (HR = 3.8, CI 95% 1.8– 7.99, p < 0.001). Patients with RDW above 14% did not have lower ejection fraction, higher CPK or more conventional risk factors.

Conclusion

RDW value above 14 is independently associated with increased long term all-cause mortality in patients with STEMI undergoing PPCI.     

红细胞分布宽度对急性重症胰腺炎患者院内死亡的预测价值

目的：探讨红细胞分布宽度（ red blood cell distribution width, RDW）对急性重症胰腺炎（ severe acute pancreatitis, SAP）患者院内死亡的预测价值。方法95例SAP患者,按住院期间是否死亡分为死亡组和非死亡组。分析两组患者的基本临床资料,通过二分类Logistic回归分析得出院内死亡的危险因素,绘制ROC曲线,分析RDW对SAP患者院内死亡的预测价值。结果死亡组的血糖、血钙、血肌酐、氧合指数、白蛋白、乳酸脱氢酶、血红蛋白、红细胞压积、RDW、APACHEⅡ评分与Ranson 评分等指标与非死亡组比较差异有统计学意义（ P＜0．05）;二分类Logistic回归分析显示,RDW、APACHEⅡ评分、Ranson 评分、白蛋白、氧合指数、血肌酐等指标为院内死亡的独立危险因素（P ＜0．05）;ROC 曲线分析显示,RDW 曲线下面积为0．907（95％CI 0．928～0．968,P＝0．000）,APACHEⅡ评分为0．864（95％CI 0．812～0．915,P＝0．000）,氧合指数为0．848（95％CI 0．785～0．833,P＝0．001）。结论 RDW是SAP患者预后的独立预测因子,对SAP患者院内死亡的预测价值较高。     

MCV、RDW检测对缺铁性贫血的临床诊断价值分析

目的:探讨MCV、RDW检测对缺铁性贫血的临床诊断价值。方法:对160例缺铁性贫血(IDA)患者进行红细胞平均体积(MCV)和红细胞体积分布宽度(RDW)检测,分析检测结果,并与健康组进行比较(健康体检者50例)。探讨其临床诊断价值。结果:IDA组MCV为(72.3±8.0)fl,RDW为(17.5±3.2)%,健康组MCV为(86.5±4.6)fl,RDW为(14.30±2.0)%,两组MCV、RDW检测值比较,差异有统计学意义(P<0.05)。IDA患者表现为MCV减低、RDW增高。结论:临床上MCV、RDW检测对诊断缺铁性贫血具有重要意义。     

Pattern of milk feeding and family size as risk factors for iron deficiency anemia among poor Egyptian infants 6 to 24 months old

Infants between 6 and 24 months of age are at the highest risk of development of iron deficiency anemia (IDA) in developing countries. Consuming unmodified cow's milk, delayed introduction of solid foods after 6 months, and high birth order could be predictors of the presence of IDA. Three hundred infants between the ages of 6 and 24 months (mean, 13.94 ± 6.17 months) from Ain Shams University Children's Hospital were enrolled in the study. Data collected included demographic information and dietary assessment including the type of milk feeding, introduction of solid foods, and daily iron intake. The infants were examined, and anthropometric measurements were recorded. Anemic infants (hemoglobin level <11 g/dL) were further evaluated by complete blood count, hemoglobin electrophoresis, and iron profile. Anemia was diagnosed among 198 infants (66%), of whom 129 (43%) had IDA. Red cell distribution width at a cutoff value of 15.8% was 86% sensitive and 74% specific in predicting IDA. The main risk factors for IDA included being between 6 and 18 months of age, of the male sex, birth order above the second order, consuming cow's milk, predominant breast-feeding beyond 6 months of age, and low daily iron intake. We conclude that IDA is the most common cause of anemia among Egyptian infants 6 to 24 months old of low socioeconomic standard. Independent clinical predictors were consuming cow's milk during the first 6 months, delayed introduction of solid foods after 6 months, and birth order beyond the second order.     

老年脑梗死、高血压与冠心病患者血清白蛋白、血小板体积及红细胞分布宽度关系的探讨

目的:探讨老年脑梗死、高血压及冠心病患者血清白蛋白浓度(Alb)、血小板体积(MPV)及红细胞分布宽度(RDW)的关系。方法:选取老年脑梗死(单纯脑梗组51例),脑梗死合并高血压及或冠心病(脑梗高冠组70例),仅有高血压及/或冠心病(单纯高冠组60例),检测各组Alb、MPV及RDW等指标,与对照组(63例)比较。结果:脑梗高冠组Alb水平最低,与单纯高冠组、对照组比较;单纯脑梗组与单纯高冠组、对照组比较,差异均具有非常显著性意义(P<0.01)。脑梗高冠组与单纯高冠组中,Alb与RBC正相关,与RDW负相关。自对照组至脑梗高冠组MPV渐增大,脑梗高冠组与对照组比较,差异具有显著性意义(P<0.05)。脑梗高冠组RDW与单纯高冠组比较,单纯脑梗组与单纯高冠组比较,差异具有显著性意义(P<0.05)。单纯脑梗组RDW与PDW正相关。结论:老年人随着心脑及二者合并病变出现,Alb渐降低,MPV渐增大,RDW增宽;老年脑梗死患者较单纯心血管病变患者更易合并营养不良及隐性缺铁,且MPV的改变与脑血管损伤范围及程度关系密切。