红细胞分布宽度与风湿性二尖瓣狭窄的存在及严重程度的关联

[Association of red blood cell distribution width with presence and severity of rheumatic mitral valve stenosis].

作者信息

Akboğa Mehmet Kadri, Abacı Adnan, Canpolat Uğur, Yayla Çağrı, Şahinarslan Asife, Açıkgöz Kadri, Çay Serkan, Topaloğlu Serkan, Aras Dursun, Aydoğdu Sinan

机构信息

Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

Department of Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey.

出版信息

Turk Kardiyol Dern Ars. 2015 Apr;43(3):227-33. doi: 10.5543/tkda.2015.60533.

DOI:10.5543/tkda.2015.60533

PMID:25905993

Abstract

OBJECTIVE

As an indicator of variability in circulating erythrocyte size, red cell distribution width (RDW) is linked to chronic inflammation. The association of rheumatic heart valve stenosis and inflammation is also well-known. This study aimed to assess the relationship between RDW and presence and severity of rheumatic mitral valve stenosis (RMVS).

METHODS

A total of 417 consecutive patients with RMVS, and 81 age- and -gender matched healthy control subjects were included in the study between February 2009 and April 2014. Transthoracic echocardiography and demographic characteristics were recorded for all participants.

RESULTS

Baseline characteristics were similar in the two groups. However, median RDW was significantly higher in patients with RMVS compared to control group (14.4% [11.3-19.6] vs. 13.6% [11.6-18.1], p<0.001). Additionally, both median C-reactive protein (CRP) and neutrophil-lymphocyte ratio (NLR) were also higher in the RMVS group; (6.1 [0.4-24.2] vs. 3.6 [0.3-15.3] mg/dl, p=0.001 for CRP, and 2.8 [0.4-10.6] vs. 2.1 [0.7-5.7], p<0.001 for NLR respectively). In regression analysis, RDW (OR: 1.504, p=0.005), CRP (OR: 1.139, p=0.008), NLR (OR: 1.528, p=0.018) and left atrial diameter (OR: 1.218, p<0.001) were found as independent predictors of the presence of RMVS. Furthermore, there was a significant positive correlation between CRP (r=0.140, p=0.007) and NLR levels (r=0.276, p<0.001) with RDW levels. Furthermore, we determined that RDW levels increased in parallel with severity of mitral stenosis (mild, moderate and severe) [13.7% (12.9-14.8), 14.4% (13.4-15.4), 14.8% (13.6-16.3), p<0.001, respectively].

CONCLUSION

The study demonstrated significantly higher RDW in patients with RMVS. Furthermore, RDW independently predicted the presence of RMVS. RDW is an easily available marker, and because of its correlation with common inflammatory indicators may also be a sign of chronic inflammatory continuum in patients with RMVS.

摘要

目的

作为循环红细胞大小变异性的指标，红细胞分布宽度（RDW）与慢性炎症相关。风湿性心脏瓣膜狭窄与炎症之间的关联也广为人知。本研究旨在评估RDW与风湿性二尖瓣狭窄（RMVS）的存在及严重程度之间的关系。

方法

2009年2月至2014年4月期间，本研究共纳入了417例连续性RMVS患者以及81例年龄和性别匹配的健康对照者。记录了所有参与者的经胸超声心动图和人口统计学特征。

结果

两组的基线特征相似。然而，RMVS患者的RDW中位数显著高于对照组（14.4% [11.3 - 19.6] 对比 13.6% [11.6 - 18.1]，p<0.001）。此外，RMVS组的C反应蛋白（CRP）中位数和中性粒细胞与淋巴细胞比值（NLR）也更高；（CRP为6.1 [0.4 - 24.2] 对比3.6 [0.3 - 15.3] mg/dl，p = 0.001；NLR分别为2.8 [0.4 - 10.6] 对比2.1 [0.7 - 5.7]，p<0.001）。在回归分析中，发现RDW（比值比：1.504，p = 0.005）、CRP（比值比：1.139，p = 0.008）、NLR（比值比：1.528，p = 0.018）和左心房直径（比值比：1.218，p<0.001）是RMVS存在的独立预测因素。此外，CRP水平（r = 0.140，p = 0.007）和NLR水平（r = 0.276，p<0.001）与RDW水平之间存在显著正相关。此外，我们确定RDW水平随着二尖瓣狭窄的严重程度（轻度、中度和重度）而平行升高[分别为13.7%（{12.9 - 14.8}）、14.4%（{13.4 - 15.4}）、14.8%（{13.6 - 16.3}），p<0.001]。