目的：红细胞分布宽度（RDW），红细胞体积的异质性的自动化措施（例如，红细胞大小不均）很大程度上被忽略的，是一个公认的心血管疾病新的危险标志，但是它在持续性病毒感染中的作用尚未被很好的界定。本研究旨在探讨红细胞分布宽度与乙肝感染者不同疾病状态之间的关联。此外，我们分析RDW与乙肝患者死亡率是否存在相关性。方法：这项研究有患者123例（包括16例急性乙肝、61例慢乙肝、46例慢性重症），健康对照组48例。所以研究对象在入院时都收集血液样本，检查肝功、肾功、国际标准化比值、血常规。结果：所有患者随访至少4个月。用Cox比例风险和多元回归模型对可能相关的10个临床化学，血液学，生化变量进行了分析。入院时慢性重症的RDW(18.30±3.11%,P<0.001), 慢乙肝RDW(16.37±2.43%, P<0.001)，急性乙肝RDW(14.38±1.72%, P<0.05) ，明显高于健康对照组。RDW的增加与严重肝病临床相关，增加了3个月的死亡率，多元分析表明RDW和终末期肝病评分模型是死亡率的独立预测指标。结论：乙肝患者RDW明显增加，并且与疾病严重程度相关。此外，RDW对于乙肝患者3个月的死亡率是一个独立预测因子
吉林大学第一医院肝胆胰内科 祁亚宾 摘译
本文首次发表于[PLoS One. 2012;7(5):e37644.]
Clinical usefulness of measuring red blood cell distribution width in patients with hepatitis B.
Abstract
BACKGROUND AND AIMS:Red blood cell distribution width (RDW), an automated measure of red blood cell size heterogeneity (e.g., anisocytosis) that is largely overlooked, is a newly recognized risk marker in patients with cardiovascular diseases, but its role in persistent viral infection has not been well-defined.
The present study was designed to investigate the association between RDW values and different disease states in hepatitis B virus (HBV)-infected patients. In addition, we analyzed whether RDW is associated with mortality in the HBV-infected patients.
METHODS:One hundred and twenty-three patients, including 16 with acute hepatitis B (AHB), 61 with chronic hepatitis B (CHB), and 46 with chronic severe hepatitis B (CSHB), and 48 healthy controls were enrolled. In all subjects, a blood sample was collected at admission to examine liver function, renal function, international normalized ratio and routine hematological testing.
RESULTS:All patients were followed up for at least 4 months. A total of 10 clinical chemistry, hematology, and biochemical variables were analyzed for possible association with outcomes by using Cox proportional hazards and multiple regression models. RDW values at admission in patients with CSHB (18.30±3.11%, P<0.001), CHB (16.37±2.43%, P<0.001) and AHB (14.38±1.72%, P<0.05) were significantly higher than those in healthy controls (13.03±1.33%).
Increased RDW values were clinically associated with severe liver disease and increased 3-month mortality rate. Multivariate analysis demonstrated that RDW values and the model for end-stage liver disease score were independent predictors for mortality (both P<0.001).
CONCLUSIONS:RDW values are significantly increased in patients with hepatitis B and associated with its severity. Moreover, RDW values are an independent predicting factor for the 3-month mortality rate in patients with hepatitis B.
