红细胞分布宽度增加是否是非酒精性脂肪性肝炎和纤维化阶段的标志物？
Is increased red cell distribution width an indicating marker of nonalcoholic steatohepatitis and fibrotic stage?
机构信息
Mustafa Cengiz, Seren Ozenirler, Department of Gastroenterology, Gazi University Faculty of Medicine, 06500 Ankara, Turkey.
出版信息
World J Gastroenterol. 2013 Nov 14;19(42):7412-8. doi: 10.3748/wjg.v19.i42.7412.
AIM
To evaluate the red cell distribution width (RDW) as an indicator of the presence of non-alcoholic steatohepatitis (NASH) and its association with fibrotic scores.
METHODS
A retrospective study was carried out that included sixty-two biopsy proven NASH, 32 simple steatosis patients and 30 healthy controls. The correlation between the clinical and histopathological features of NASH patients and RDW values was evaluated. Liver fibrosis scores were measured using a 0 to 4 point scale and were divided in to two groups; fibrosis scores 0-1 were termed mild and fibrosis scores 2-4 were termed advanced fibrosis. RDW values were compared between NASH, simple steatosis and healthy controls. Univariate and multivariate analyses were performed to evaluate the independent predicting factors for the presence of liver fibrosis caused by NASH.
RESULTS
Patients with NASH had higher RDW values compared with simple steatosis and healthy control groups [14.28% ± 0.25% vs 13.37% ± 0.12%, 12.96% ± 0.14% (P < 0.01), respectively]. Patients with advanced fibrosis had higher RDW values than the mild fibrosis group (15.86% ± 0.4% vs 13.63% ± 0.67%, P < 0.01, respectively). RDW also correlated with fibrotic scores (r = 0.579 and P < 0.01). The variables that were significant in the univariate analysis were evaluated in multivariate logistic regression analysis, and RDW was an independent predicting factor of NASH (OR = 1.75, 95%CI: 1.129-2.711, P < 0.05).
CONCLUSION
RDW a new non-invasive marker that can be used to demonstrate the presence of NASH and indicate advanced fibrotic scores.
目的
评估红细胞分布宽度（RDW）作为非酒精性脂肪性肝炎（NASH）存在的指标及其与纤维化评分的关系。
方法
进行了一项回顾性研究，纳入了 62 例经活检证实的 NASH 患者、32 例单纯性脂肪变性患者和 30 例健康对照者。评估了 NASH 患者的临床和组织病理学特征与 RDW 值之间的相关性。使用 0 至 4 分的评分系统测量肝纤维化评分，并将其分为两组；纤维化评分 0-1 称为轻度，纤维化评分 2-4 称为晚期纤维化。比较 NASH、单纯性脂肪变性和健康对照组之间的 RDW 值。进行单因素和多因素分析，以评估 NASH 引起的肝纤维化存在的独立预测因素。
结果
与单纯性脂肪变性和健康对照组相比，NASH 患者的 RDW 值更高[14.28%±0.25%比 13.37%±0.12%，12.96%±0.14%（P<0.01）]。晚期纤维化组的 RDW 值高于轻度纤维化组（15.86%±0.4%比 13.63%±0.67%，P<0.01）。RDW 与纤维化评分呈正相关（r=0.579，P<0.01）。单因素分析中具有统计学意义的变量在多因素逻辑回归分析中进行了评估，RDW 是 NASH 的独立预测因素（OR=1.75，95%CI：1.129-2.711，P<0.05）。
结论
RDW 是一种新的非侵入性标志物，可用于证明 NASH 的存在，并提示晚期纤维化评分。
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