Department of Laboratory Medicine, General Hospital of Ji ’ nan Military Command Region, Ji'nan, PR China.
Clin Chem Lab Med. 2013 Jul;51(7):1403-8. doi: 10.1515/cclm-2012-0704.
Red blood cell distribution width (RDW) is increased in liver disease. Its clinical significance, however, remains largely unknown. The aim of this study was to identify whether RDW was a prognostic index for liver disease.
We studied, retrospectively, 33 patients with non-cirrhotic HBV chronic hepatitis, 125 patients with liver cirrhosis after HBV infection, 81 newly diagnosed primary hepatocellular carcinoma (pHCC) patients, 17 alcoholic liver cirrhosis patients and 42 patients with primary biliary cirrhosis (PBC). Sixty-six healthy individuals represented the control cohort. We analyzed the relationship between RDW on admission and clinical features. The association between RDW and hospitalization outcome was estimated by receiver operating curve (ROC) analysis and a multivariable logistic regression model.
Increased RDW was observed in liver disease patients. RDW was positively correlated with serum bilirubin and creatinine levels, prothrombin time, and negatively correlated with platelet counts and serum albumin concentration. A subgroup analysis, considering the different etiologies, revealed similar findings. Among the patients with liver cirrhosis, RDW increased with worsening of Child-Pugh grade. In patients with PBC, RDW positively correlated with Mayo risk score. Increased RDW was associated with worse hospital outcome, as shown by the AUC [95% confidence interval (CI)] of 0.76 (0.67-0.84). RDW above 15.15% was independently associated with poor hospital outcome after adjustment for serum bilirubin, platelet count, prothrombin time, albumin and age, with the odds ratio (95% CI) of 13.29 (1.67-105.68).
RDW is a potential prognostic index for liver disease.
红细胞分布宽度（RDW）在肝病中增加。然而，其临床意义在很大程度上尚不清楚。本研究的目的是确定 RDW 是否是肝病的预后指标。
我们回顾性研究了 33 例非肝硬化乙型肝炎慢性肝炎患者、125 例乙型肝炎感染后肝硬化患者、81 例新诊断的原发性肝细胞癌（pHCC）患者、17 例酒精性肝硬化患者和 42 例原发性胆汁性肝硬化（PBC）患者。66 名健康个体作为对照组。我们分析了入院时 RDW 与临床特征之间的关系。通过接收者操作曲线（ROC）分析和多变量逻辑回归模型来评估 RDW 与住院结局之间的关联。
在肝病患者中观察到 RDW 增加。RDW 与血清胆红素和肌酐水平呈正相关，与血小板计数和血清白蛋白浓度呈负相关。考虑不同病因的亚组分析得出了类似的发现。在肝硬化患者中，随着 Child-Pugh 分级的恶化，RDW 增加。在 PBC 患者中，RDW 与 Mayo 风险评分呈正相关。增加的 RDW 与较差的住院结局相关，AUC（95%CI）为 0.76（0.67-0.84）。在校正血清胆红素、血小板计数、凝血酶原时间、白蛋白和年龄后，RDW 高于 15.15% 与不良住院结局独立相关，优势比（95%CI）为 13.29（1.67-105.68）。
RDW 是肝病的一个潜在预后指标。
