Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
COPD. 2013 Aug;10(4):416-24. doi: 10.3109/15412555.2012.758697. Epub 2013 Mar 28.
Cardiovascular disease (CVD) contributes significantly to mortality in chronic obstructive pulmonary disease (COPD). Red blood cell distribution width (RDW), an automated measure of red blood cell size heterogeneity that is largely overlooked, is a newly recognized mortality marker in patients with established CVD. It is unknown whether RDW is associated with mortality in COPD patients.
To study the prognostic value of RDW in patients with COPD and to compare the value of this measurement with cardiac, respiratory, and hemotological status.
We performed retrospective analyses of 270 patients stable with COPD who were admitted to our hospital between January 2007 and December 2009. Demographic, clinical, echocardiographic, and laboratory characteristics were registered and recorded COPD deaths were registered as outcomes.
In the overall patients, the RDW level had a mean value of 15.1 ± 2.4. RDW was positively correlated with C-reactive protein (CRP) (p = 0.008, r = 0.21), right ventricular dysfunction (RVD) (p < 0.001, r = 0.25), and pulmonary arterial hypertension (PAH) (p = 0.03, r = 0.14). Variables (p < 0.1) included in the univariate survival analysis were forced expiratory volume in 1 second (FEV1% predicted), RDW levels, age, PaCO2, albumine and CRP levels, presence of CVD, presence of anemia, presence of RVD, and presence of PAH. Subsequent multivariate analysis suggested that RDW levels (1.12; 95% CI, 1.01 to 1.24; p = 0.01), and presence of RVD (2.6; 95% CI, 1.19 to 5.8; p = 0.01) were independently related to mortality.
Elevated RDW levels were associated with increased mortality risk in stable COPD patients.
心血管疾病（CVD）在慢性阻塞性肺疾病（COPD）患者的死亡率中占很大比例。红细胞分布宽度（RDW）是一种自动测量红细胞大小异质性的指标，在很大程度上被忽视，但它是已确诊 CVD 患者新的死亡标志物。目前尚不清楚 RDW 是否与 COPD 患者的死亡率相关。
研究 RDW 在 COPD 患者中的预后价值，并比较该测量值与心脏、呼吸和血液状态的价值。
我们对 2007 年 1 月至 2009 年 12 月间我院收治的 270 例稳定 COPD 患者进行了回顾性分析。登记了人口统计学、临床、超声心动图和实验室特征，并记录了 COPD 死亡作为结局。
在所有患者中，RDW 水平的平均值为 15.1±2.4。RDW 与 C 反应蛋白（CRP）呈正相关（p=0.008，r=0.21），与右心室功能障碍（RVD）（p<0.001，r=0.25）和肺动脉高压（PAH）（p=0.03，r=0.14）呈正相关。单变量生存分析中包含的变量（p<0.1）包括：第 1 秒用力呼气量（FEV1%预计值）、RDW 水平、年龄、PaCO2、白蛋白和 CRP 水平、CVD 存在、贫血存在、RVD 存在和 PAH 存在。随后的多变量分析表明，RDW 水平（1.12；95%置信区间，1.01 至 1.24；p=0.01）和 RVD 存在（2.6；95%置信区间，1.19 至 5.8；p=0.01）与死亡率独立相关。
在稳定的 COPD 患者中，升高的 RDW 水平与更高的死亡风险相关。
