Red blood cell distribution width as a related factor of pulmonary arterial hypertension in patients with systemic sclerosis
Red blood cell distribution width as a related factor of pulmonary arterial hypertension in patients with systemic sclerosis
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系统性硬化症患者红细胞分布宽度与肺动脉高压的相关因素
DOI：
10.1007/s10067-017-3918-9
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发表时间：
2018-04-01
影响因子：
3.4
通讯作者：
Zeng, Xiaofeng
中科院分区：
文献类型：
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作者：
Zhao, Jiuliang;Mo, Hongnan;Zeng, Xiaofeng
本研究的目的是探讨红细胞分布宽度（RDW）作为系统性硬化症（SSc）患者肺动脉高压（PAH）发生的简单且容易获得的标志物的实用性。145名SSc患者被连续招募到单中心横断面研究中。测定人口统计学特征、血液学参数、改良罗德曼皮肤评分和世界卫生组织功能分类。PAH的诊断是基于超声心动图的筛查，并通过右心导管确认。间质性肺疾病（ILD）的诊断是基于胸部高分辨率计算机断层扫描结果。局限性和弥漫性SSc组在性别、年龄或病程上无显著差异。lcSSc 28例（33.3%），dcSSc 14例（23.0%）检出PAH。RDW值较高的患者更可能是具有高抗u1rnp滴度和PAH的男性。RDW与高敏c反应蛋白（p= 0.375,p< 0.01）与肺对一氧化碳的弥散能力（p= - 0.396,p< 0.01）呈显著相关。SSc- pah组的RDW值明显高于无肺部疾病的SSc组（15.7±2.2和13.7±1.0,p <0.001）。SSc-PAH-ILD组的平均RDW显著高于SSc-ILD组（16.3±2.2%和14.0±1.5%,p< 0.001）。除了已知的危险因素外，高RDW是SSc患者PAH的独立预测因子（OR = 3.314 [95%CI 1.038 ~ 10.580],p< 0.05）。RDW可能是鉴别SSc患者肺动脉高压的一个相关因素。
The aim of this study was to investigate the utility of red blood cell distribution width (RDW) as a simple and readily available marker of occurrence of pulmonary arterial hypertension (PAH) in patients with systemic sclerosis (SSc). One hundred and forty-five consecutive patients with SSc were recruited to the single-center cross-sectional study. Demographic characteristics, hematological parameters, Modified Rodnan Skin Score, and World Health Organization functional classification were determined. Diagnosis of PAH was based on screening by echocardiography and was confirmed by right heart catheterization. Interstitial lung disease (ILD) was diagnosed based on chest high-resolution computed tomography findings. There were no significant differences in gender, age, or disease duration between limited and diffused SSc groups. PAH was detected in 28 of lcSSc (33.3%) and 14 of dcSSc (23.0%) subjects. Patients with higher RDW values were more likely to be men with high anti-u1RNP titers and PAH. A significant correlation was found between RDW and high-sensitivity C-reactive protein (p= 0.375,p< 0.01) and the diffusing capacity of the lungs for carbon monoxide (ρ= − 0.396,p< 0.01). The SSc-PAH group had significantly higher RDW values compared to the SSc group without pulmonary disease (15.7 ± 2.2 and 13.7 ± 1.0,p <0.001). The mean RDW in the SSc-PAH-ILD group was significantly higher than that in the SSc-ILD group (16.3 ± 2.2% and 14.0 ± 1.5%,p< 0.001). Besides the recognized risk factors, high RDW was an independent predictor of PAH in patients with SSc (OR = 3.314 [95%CI 1.038–10.580],p< 0.05). RDW may be a related factor for identifying the pulmonary arterial hypertension in SSc patients.