Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
Clin Chim Acta. 2018 Jul;482:155-160. doi: 10.1016/j.cca.2018.04.002. Epub 2018 Apr 6.
Red blood cell distribution width (RDW) has been indicated to be an inflammatory indicator in a variety of diseases. However, no consistent conclusions regarding it's relevance to hepatitis B virus (HBV) -related liver diseases have been made. This meta-analysis was conducted to assess the significance of RDW in HBV-related liver diseases.
A comprehensive literature review was conducted using PubMed, Embase, and China National Knowledge Infrastructure (CNKI) through August 20, 2017 to identify studies that reported the association between RDW and HBV-related liver diseases. The standard mean difference (SMD) and corresponding 95% confidence interval (CI) were used to assess the associations.
Twenty-four studies met the eligibility criteria were included in the meta-analysis. These studies included 3272 HBV-infected patients and 2209 healthy controls. Chronic hepatitis B (CHB) patients had significantly increased RDW levels compared with healthy controls (SMD =1.399, 95% CI 0.971-1.827, p < 0.001]. Moreover, acute on chronic liver failure (ACLF) patients (SMD = 1.309, 95% CI 0.775-1.843, p < 0.001) and cirrhotic patients (SMD = 0.948, 95% CI 0.715-1.180, p < 0.001) had significantly elevated RDW levels compared with CHB patients. However, no statistical significance was obtained in RDW levels between cirrhosis and ACLF (SMD = 0.167, 95% CI -0.382 -0.716, p = 0.051).
RDW values were elevated in HBV-related liver diseases and correlated with the disease severity, suggesting that RDW levels may differentiate CHB from healthy controls and ACLF and cirrhosis from CHB but they appear to have no distinguishing characteristic between ACLF and cirrhosis.
红细胞分布宽度（RDW）已被证实为多种疾病的炎症指标。然而，关于其与乙型肝炎病毒（HBV）相关肝病的相关性尚未得出一致的结论。本荟萃分析旨在评估 RDW 在 HBV 相关肝病中的意义。
通过 2017 年 8 月 20 日之前的 PubMed、Embase 和中国知网（CNKI）进行全面文献检索，以确定报告 RDW 与 HBV 相关肝病之间关系的研究。使用标准均数差（SMD）和相应的 95％置信区间（CI）来评估相关性。
共有 24 项符合纳入标准的研究被纳入荟萃分析。这些研究包括 3272 例 HBV 感染患者和 2209 例健康对照者。与健康对照组相比，慢性乙型肝炎（CHB）患者的 RDW 水平显著升高（SMD=1.399，95％CI 0.971-1.827，p<0.001）。此外，慢加急性肝衰竭（ACLF）患者（SMD=1.309，95％CI 0.775-1.843，p<0.001）和肝硬化患者（SMD=0.948，95％CI 0.715-1.180，p<0.001）的 RDW 水平也显著升高。然而，肝硬化与 ACLF 患者之间的 RDW 水平无统计学差异（SMD=0.167，95％CI -0.382 -0.716，p=0.051）。
HBV 相关肝病患者的 RDW 值升高，与疾病严重程度相关，表明 RDW 水平可区分 CHB 与健康对照者、ACLF 与肝硬化，但在 ACLF 与肝硬化之间似乎没有鉴别特征。
