Department of Respiratory Medicine, The Huaian Clinical College of Xuzhou Medical University, Huaian 223001, China.
Anal Cell Pathol (Amst). 2020 Jul 21;2020:1935742. doi: 10.1155/2020/1935742. eCollection 2020.
This study is aimed at investigating the relationship between red cell distribution width (RDW) and chronic obstructive pulmonary disease (COPD) patients with pulmonary embolism (PE).
We conducted a retrospective study enrolling a total of 125 patients from January 2013 to December 2019. The study group consisted of 40 COPD patients with PE, and the control group had 85 COPD patients without PE. Clinical data including demographic characteristics, comorbidities, and results of imaging examinations and laboratory tests were recorded. Blood biomarkers, including red blood cell distribution width standard deviation (RDW-SD), red blood cell distribution width coefficient of variation (RDW-CV), and D-Dimer, were included.
RDW-SD and RDW-CV were higher in the COPD patients with the PE group ( < 0.001). A higher RDW-SD led to a significantly increased risk of PE than a lower RDW-SD (adjusted odds ratio (OR): 1.188; 95% confidence interval (CI): 1.048-1.348). The area under the curve (AUC) of RDW-SD used for predicting PE was 0.737. Using 44.55 as the cutoff value of RDW-SD, the sensitivity was 80% and the specificity was 64.7%. The prediction accuracy of RDW-SD combined with D-Dimer (AUC = 0.897) was higher than that of RDW-SD or D-Dimer alone. The optimal cutoff value of RDW-SD+D-Dimer for predicting PE was 0.266, which generated a sensitivity of 87.5% and specificity of 83.5%.
RDW is significantly increased in COPD patients with PE and may thus be useful in predicting the occurrence of PE in patients with COPD.
本研究旨在探讨红细胞分布宽度（RDW）与合并肺栓塞（PE）的慢性阻塞性肺疾病（COPD）患者的关系。
我们进行了一项回顾性研究，纳入了 2013 年 1 月至 2019 年 12 月期间的 125 名患者。研究组由 40 名合并 PE 的 COPD 患者组成，对照组由 85 名不合并 PE 的 COPD 患者组成。记录了患者的临床资料，包括人口统计学特征、合并症以及影像学检查和实验室检查结果。血液生物标志物包括红细胞分布宽度标准差（RDW-SD）、红细胞分布宽度变异系数（RDW-CV）和 D-二聚体。
PE 组 COPD 患者的 RDW-SD 和 RDW-CV 均较高（<0.001）。RDW-SD 较高与发生 PE 的风险显著增加相关（调整后的优势比（OR）：1.188；95%置信区间（CI）：1.048-1.348）。RDW-SD 预测 PE 的曲线下面积（AUC）为 0.737。使用 44.55 作为 RDW-SD 的截断值，其灵敏度为 80%，特异性为 64.7%。RDW-SD 联合 D-二聚体（AUC=0.897）的预测准确性高于 RDW-SD 或 D-二聚体单独使用。RDW-SD+D-二聚体预测 PE 的最佳截断值为 0.266，其灵敏度为 87.5%，特异性为 83.5%。
PE 合并 COPD 患者的 RDW 显著增加，因此可能有助于预测 COPD 患者发生 PE 的可能性。
