Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108, Pyung-Dong, Jongro-Ku, Seoul 110-746, Korea.
Dig Dis Sci. 2012 Apr;57(4):1033-8. doi: 10.1007/s10620-011-1978-2. Epub 2011 Dec 7.
Recent studies have suggested that a higher red blood cell distribution width (RDW) is associated with disease activity in patients with inflammatory bowel disease (IBD). However, the RDW in IBD patients without anemia has not been investigated.
This study aimed to determine whether or not RDW could be used for the assessment of disease activity in IBD patients with and without anemia.
The serum C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), hemoglobin concentration, platelet and white blood cell counts, and RDW were assessed in 221 IBD patients, comprised of 120 patients with ulcerative colitis (UC) and 101 patients with Crohn's disease (CD). Disease activity was determined for UC and CD with the Mayo score and the Crohn's disease activity index, respectively.
The CRP level, ESR, hemoglobin concentration, hematocrit, and RDW increased according to disease activity in patients with and without anemia (all P < 0.05). Multivariate analysis demonstrated that RDW was the best independent indicator for predicting disease activity in CD patients without anemia [odd ratios (OR), 1.702; 95% confidence interval (CI), 1.185-2.445; P = 0.004] and UC patients without anemia (OR, 4.921; 95% CI, 2.281-10.615; P < 0.001). Also, ROC curve analysis showed the RDW to be the most significant indicator of non-anemic active IBD [area under curve (AUC) in CD, 0.852, P < 0.001; AUC in UC, 0.827, P < 0.001].
The association between increased RDW and active IBD was evident in IBD patients with and without anemia.
最近的研究表明，较高的红细胞分布宽度（RDW）与炎症性肠病（IBD）患者的疾病活动有关。然而，尚未研究无贫血的 IBD 患者的 RDW。
本研究旨在确定 RDW 是否可用于评估有和无贫血的 IBD 患者的疾病活动。
评估了 221 例 IBD 患者的血清 C 反应蛋白（CRP）水平、红细胞沉降率（ESR）、血红蛋白浓度、血小板和白细胞计数以及 RDW，这些患者包括 120 例溃疡性结肠炎（UC）患者和 101 例克罗恩病（CD）患者。使用 Mayo 评分和克罗恩病活动指数分别确定 UC 和 CD 的疾病活动。
CRP 水平、ESR、血红蛋白浓度、红细胞压积和 RDW 在有和无贫血的患者中均随疾病活动而增加（均 P < 0.05）。多变量分析表明，RDW 是预测无贫血 CD 患者（比值比 [OR]，1.702；95%置信区间 [CI]，1.185-2.445；P = 0.004）和无贫血 UC 患者（OR，4.921；95%CI，2.281-10.615；P < 0.001）疾病活动的最佳独立指标。此外，ROC 曲线分析表明 RDW 是无贫血活动性 IBD 的最重要指标[CD 的曲线下面积（AUC），0.852，P < 0.001；UC 的 AUC，0.827，P < 0.001]。
RDW 增加与有和无贫血的 IBD 患者的活动性 IBD 之间存在关联。
