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探讨红细胞分布宽度作为慢性阻塞性肺疾病患者一年内病情恶化预后指标的效用。

Investigating the Utility of Red Blood Cell Distribution Width as a Prognostic Indicator for Deterioration of Patients with Chronic Obstructive Pulmonary Disease Within One Year.

作者信息

Liu Qianfeng, Wu Kangbi, Lin Xiaofang, Xiang Kali, Wang Jing

机构信息

Department of Pulmonary and Critical Care Medicine, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi City, Hubei, People's Republic of China.

出版信息

Int J Gen Med. 2024 Sep 6;17:3869-3877. doi: 10.2147/IJGM.S469209. eCollection 2024.

DOI:10.2147/IJGM.S469209
PMID:39263590
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11387594/
Abstract

BACKGROUND

Considerable studies have demonstrated a significant association between red blood cell distribution width (RDW) and clinical adverse events in cardiovascular or respiratory diseases, infections, and pulmonary embolism. However, there are limited data on prognostic predictions for patients suffering from chronic obstructive pulmonary disease (COPD).

METHODS

This study conducted a retrospective cohort analysis using data gathered from patients who diagnosed with COPD in the respiratory department of The Central hospital of Enshi Tujia and Miao Autonomous Prefecture between 2018 and 2021. Specifically, the RDW was recorded on their first admission. Multivariate logistic regression analysis were employed to examine the correlation between RDW and deterioration of COPD within one-year period.

RESULTS

The cohort of 1799 patients in the study comprised 74.7% male and had an average age of 68.9 ± 9.9 years. The fully adjusted model revealed that, the RDW-middle group (≤13.7,>12.8; OR 1.5, 95% CI 1.0-2.3, =0.055) and the RDW-high group (>13.7; OR 1.7, 95% CI 1.1-2.6, =0.013) had a 50% and 70% increased risk of deterioration within 1 year, respectively, in comparison with the RDW-low group (≤12.8). Subgroup analysis indicated that this trend was more significant in patients with hypertension ( for interaction = 0.016), and the probability of deterioration within 1 year in the RDW-high group was 3.3 times higher compared to the RDW-low group (OR 3.3, 95% CI 1.4-7.9, =0.008).

CONCLUSION

A significant association was observed between the increase in RDW and the heightened risk of deterioration within a year in patients diagnosed with COPD. Most importantly, our findings suggested the importance of RDW in enhancing the risk stratification and prevention of deterioration of COPD.

摘要

背景

大量研究表明,红细胞分布宽度(RDW)与心血管或呼吸系统疾病、感染及肺栓塞的临床不良事件之间存在显著关联。然而,关于慢性阻塞性肺疾病(COPD)患者预后预测的数据有限。

方法

本研究采用回顾性队列分析,使用2018年至2021年期间在恩施土家族苗族自治州中心医院呼吸科诊断为COPD的患者收集的数据。具体而言,记录他们首次入院时的RDW。采用多因素逻辑回归分析来检验RDW与COPD在1年内病情恶化之间的相关性。

结果

该研究中的1799名患者队列中,男性占74.7%,平均年龄为68.9±9.9岁。完全调整模型显示,与RDW低组(≤12.8)相比,RDW中等组(≤13.7,>12.8;比值比[OR]1.5,95%置信区间[CI]1.0 - 2.3,P = 0.055)和RDW高组(>13.7;OR 1.7,95% CI 1.1 - 2.6,P = 0.013)在1年内病情恶化的风险分别增加了50%和70%。亚组分析表明,这种趋势在高血压患者中更为显著(交互作用P = 0.016),RDW高组1年内病情恶化的概率是RDW低组的3.3倍(OR 3.3,95% CI 1.4 - 7.9,P = 0.008)。

结论

在诊断为COPD的患者中,观察到RDW升高与1年内病情恶化风险增加之间存在显著关联。最重要的是,我们的研究结果表明RDW在加强COPD风险分层和预防病情恶化方面具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c394/11387594/f37e86a4cee1/IJGM-17-3869-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c394/11387594/f37e86a4cee1/IJGM-17-3869-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c394/11387594/f37e86a4cee1/IJGM-17-3869-g0001.jpg

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