摘要
目的研究肝硬化患者红细胞分布宽度(RDW)变异系数(RDW-CV)、红细胞分布宽度标准差(RDW-SD)变化规律,并探讨二者鉴别诊断肝硬化代偿期与失代偿期的临床价值。方法选取肝硬化患者120例,其中代偿期与失代偿期患者各60例。比较RDW-CV、RDW-SD在不同肝硬化阶段的差异,研究RDW-CV、RDW-SD与肝功能指标总蛋白(TP)、白蛋白(ALB)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(γ-GT)以及炎症指标C反应蛋白(CRP)的相关性。以受试者工作特征(ROC)曲线评估RDW-CV、RDW-SD在诊断肝硬化失代偿期的特异性和敏感性。结果肝硬化代偿组患者RDW-CV和RDW-SD均低于失代偿组患者,其中RDW-SD差异更明显(P<0.001)。肝硬化代偿组患者RDW-SD、RDW-CV与TP均呈负相关,此外,RDW-SD还与γ-GT正相关;肝硬化失代偿组患者RDW-SD与ALB负相关,与TP、ALT、AST和TBIL均呈正相关,RDW-CV与TP、ALT和TBIL也呈正相关,但相关性不及RDW-SD。肝硬化失代偿组患者CRP与RDW-SD呈正相关,却与RDW-CV无相关性。ROC曲线分析显示,RDW-SD的曲线下面积(AUC)为0.788,高于RDW-CV的0.648。结论RDW-CV和RDW-SD在不同肝硬化阶段存在差异,RDW-SD差异更为明显,具有潜在鉴别诊断肝硬化患者失代偿期的临床价值。
Objective To study the changes of red blood cell distribution width(RDW)coefficient of variation(RDW-CV)and red blood cell distribution width standard deviation(RDW-SD)in patients with cirrhosis,and to explore the clinical significance of RDW-CV and RDW-SD in the differential diagnosis of compensatory and decompensated cirrhosis.Methods A total of 120 inpatients with cirrhosis diagnosed were selected,including 60 patients at the compensatory stage and 60 patients at the decompensation stage.The differences between RDW-CV and RDW-SD in patients at different stages were analyzed,and then the correlation of RDW-CV,RDW-SD with liver function indexes total protein(TP),albumin(ALB),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),alkaline phosphatase(ALP),γ-glutamyl transpeptidase(γ-GT)and inflammation indexes C-reaction protein(CRP)was discussed.Receiver operating characteristic curve(ROC)curve evaluated the specificity and sensitivity of RDW-CV and RDW-SD in the diagnosis of decompensated cirrhosis.Results Both RDW-CV and RDW-SD in the compensation period were lower than that in the decompensation period,while RDW-SD was more significant(P<0.001).In the compensatory stage of cirrhosis,RDW-SD and RDW-CV were negatively correlated with TP,in addition,RDW-SD was positively correlated withγ-GT;In the decompensated stage,RDW-SD was negatively correlated with ALB and positively correlated with TP,ALT,AST and TBIL.However,RDW-CV was also positively correlated with TP,ALT and TBIL,but the correlation was not as good as that of RDW-SD.CRP at decompensation was significantly positively correlated with RDW-SD,but not with RDW-CV.ROC curve analysis showed that the area under curve(AUC)of RDW-SD was 0.788,significantly higher than that of RDW-CV(0.648).Conclusion There are differences between RDW-CV and RDW-SD in different stages of cirrhosis,and the difference between RDW-SD is more significant,which has potential clinical value in differential diagnosis of decompens-ated cirrhosis.
作者
孙蓓蓓
周强
张浩
Sun Beibei;Zhou Qiang;Zhang Hao(Dept of Clinical Laboratory,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601)
出处
《安徽医科大学学报》
CAS
北大核心
2021年第6期938-941,共4页
Acta Universitatis Medicinalis Anhui
基金
安徽高校自然科学研究项目(编号:KJ2019A0276)
安徽医科大学校科研基金项目(编号:2017xkj041)。
