Gorial Faiq I, Hassan Ali M
Rheumatology Unit, Department of Medicine, Collage of Medicine, University of Bagdad, Iraq.
Baghdad Teaching Hospital, Rheumatology Unit, Baghdad, Iraq.
Arthritis. 2018 Aug 5;2018:2904694. doi: 10.1155/2018/2904694. eCollection 2018.
Ankylosing spondylitis (AS) is a chronic, progressive inflammatory rheumatic disease that leads to structural damage, functional impairment, and decrease in the quality of life. Red cell distribution width (RDW) is a part of the complete blood count (CBC) and estimates erythrocyte variability.
To analyse RDW in patients with AS and to evaluate the relationships with acute phase reactants (APRs) and disease activity index.
A total of 100 patients with AS (78 males and 22 females) were diagnosed according to the modified New York classification criteria for AS and 146 (99 males: 47 females) healthy individuals matched in age and sex as controls enrolled in the study. Demographic data, disease activity scores using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), medical history, C-reactive protein (CRP), erythrocytes sedimentation rate (ESR), and complete blood count (CBC) were measured.
The mean age for patients and controls was 38.0 ± 9.0 and 35.8 ± 9.0 years, respectively (p=0.057). RDW was significantly higher in patients with AS compared with controls (14.133 ± 1.613 versus 12.299 ± 1.031, p < 0.001). There was a direct correlation of RDW with both ESR and CRP (P < 0.001); RDW had r=0.38 for C-reactive protein (CRP) and r=0.413 for ESR. Also BASDAI was directly correlated with RDW (r=0.326 p<0.001). RDW was a valid measure to differentiate between patients with AS and controls (AUC=0,84, p<0.001) and at optimum cut-off value>13% has highest accuracy (78.9%) with very good sensitivity test (81%) and NPV (85.6%) as well as good specificity (77.4%) and PPV (71.1%).
RDW was higher in AS patients compared with controls and was directly correlated with ESR, CRP, and BASDAI. RDW was a valid simple measure with good accuracy to differentiate between patients with AS and controls.
强直性脊柱炎（AS）是一种慢性进行性炎性风湿性疾病，可导致结构损伤、功能障碍及生活质量下降。红细胞分布宽度（RDW）是全血细胞计数（CBC）的一部分，用于评估红细胞变异性。
分析强直性脊柱炎患者的红细胞分布宽度，并评估其与急性期反应物（APR）及疾病活动指数的关系。
根据改良的纽约AS分类标准，共纳入100例AS患者（78例男性，22例女性），并纳入146例年龄和性别匹配的健康个体作为对照。测量人口统计学数据、使用巴斯强直性脊柱炎疾病活动指数（BASDAI）的疾病活动评分、病史、C反应蛋白（CRP）、红细胞沉降率（ESR）及全血细胞计数（CBC）。
患者和对照组的平均年龄分别为38.0±9.0岁和35.8±9.0岁（p=0.057）。与对照组相比，AS患者的RDW显著更高（14.133±1.613对12.299±1.031，p<0.001）。RDW与ESR和CRP均呈正相关（P<0.001）；RDW与C反应蛋白（CRP）的相关系数r=0.38，与ESR的相关系数r=0.413。此外，BASDAI与RDW呈正相关（r=0.326，p<0.001）。RDW是区分AS患者与对照组的有效指标（AUC=0.84，p<0.001），最佳截断值>13%时具有最高准确性（78.9%），敏感性试验（81%）和阴性预测值（85.6%）良好，特异性（77.4%）和阳性预测值（71.1%）也较好。
与对照组相比，AS患者的RDW更高，且与ESR、CRP和BASDAI直接相关。RDW是区分AS患者与对照组的有效且简单的指标，准确性良好。
