红细胞分布宽度与心血管疾病关系的研究进展
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摘要
在临床血常规的检测中,红细胞分布宽度(RDW)具有重要意义,可反映外周循环血液中红细胞变异性,以往多用于不同类型的贫血诊断及鉴别诊断。近年来,人们发现RDW对急性冠状动脉综合征、心房颤动、心力衰竭、高血压、肺动脉高压、外周血管疾病、缺血性脑病等疾病的发生发展、严重程度、并发症及预后具有预测价值,且与一些心脏手术(射频消融术、冠状动脉旁路移植术、瓣膜术等)的预后也具有相关性。未来,RDW有望成为一种预测心血管疾病的标志物,进而在临床广泛应用。
Red blood cell distribution width( RDW) plays an important role in clinical routine blood test. It can reflect the variability of red blood cells in peripheral circulation. It has been used in the diagnosis and differential diagnosis of different types of anemia in the past. In recent years,it has been found that RDW has predictive value for the development,severity,complications and prognosis of acute coronary syndrome,atrial fibrillation,heart failure,hypertension,pulmonary hypertension,peripheral vascular disease,ischemic encephalopathy,etc.,and is also relevant to the prognosis of some cardiac procedures( radiofrequency ablation,coronary artery bypass grafting,valvuloplasty,etc.). In the future,RDW is expected to become a predictor of cardiovascular disease and be widely used in clinical practice.
Red blood cell distribution width( RDW) plays an important role in clinical routine blood test. It can reflect the variability of red blood cells in peripheral circulation. It has been used in the diagnosis and differential diagnosis of different types of anemia in the past. In recent years,it has been found that RDW has predictive value for the development,severity,complications and prognosis of acute coronary syndrome,atrial fibrillation,heart failure,hypertension,pulmonary hypertension,peripheral vascular disease,ischemic encephalopathy,etc.,and is also relevant to the prognosis of some cardiac procedures( radiofrequency ablation,coronary artery bypass grafting,valvuloplasty,etc.). In the future,RDW is expected to become a predictor of cardiovascular disease and be widely used in clinical practice.
引文
[1]Buttarello M.Laboratory diagnosis of anemia:Are the old and new red cell parameters useful in classification and treatment,how?[J].Int J Laborat Hematol,2016,38 Suppl 1:123-132.
[2]陈奕农,胡仁平,汪南田.动脉粥样硬化性脑梗死与红细胞分布宽度相关性研究[J].安徽医学,2016,37(6):743-745.
[3]Ycas JW,Horrow JC,Horne BD.Persistent increase in red cell size distribution width after acute diseases:A biomarker of hypoxemia?[J].Clin Chim Acta,2015,448:107-117.
[4]Lippi G,Mattiuzzi C.The biomarker paradigm:Between diagnostic efficiency and clinical efficacy[J].Pol Arch Med Wewn,2015,125(4):282-288.
[5]LappéJM,Horne BD,Shah SH,et al.Red cell distribution width,C-reactive protein,the complete blood count,and mortality in patients with coronary disease and a normal comparison population[J].Clin Chim Acta,2011,412(23/24):2094-2099.
[6]Patel HH,Patel HR,Higgins JM.Modulation of red blood cell population dynamics is a fundamental homeostatic response to disease[J].Am J Hematol,2015,90(5):422-428.
[7]Lippi G,Filippazzi L,Montagnana M,et al.Clinical usefulness of measuring red blood cell distribution width acute coronary syndromes[J].Clin Chem Lab Med,2009,47(3):353-357.
[8]Nagula P,Karumuri S,Otikunta AN,et al."Correlation of red blood cell distribution width with the severity of coronary artery disease-A single center study"[J].Indian Heart J,2015,69(6):757-761.
[9]Zalawadiya SK,Veeranna V,Niraj A,et al.Red cell distribution width and risk of coronary heart disease events[J].Am J Cardiol,2010,106(7):988-993.
[10]Kara9aglar E,Bal U,HasrcS,et al.Coronary artery disease detected by coronary computed tomography angiography is associated with red cell distribution width[J].Turk Kardiyol Dern Ars,2016,44(7):570-574.
[11]陶波,蒋学俊.红细胞分布宽度与冠心病病变程度的关系.岭南心血管病杂志,2016,22(5):544-548.
[12]Patel KV,Semba RD,Ferrucci L,et al.Red cell distribution width and mortality in older adults:A meta-analysis[J].J Gerontol ABiol Sci Med Sci,2010,65(3):258-265.
[13]Tonelli M,Sacks F,Arnold M,et al.Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease[J].Circulation,2008,117(2):163-168.
[14]Sun XP,Chen WM,Sun ZJ,et al."Impact of red blood cell distribution width on long-term mortality in patients with ST-elevation myocardial infarction"[J].Cardiology,2014,128(4):343-348.
[15]Linden F,Domschke G,Erbel C,et al.Inflammatory therapeutic targets in coronary atheroselerosis-from molecular biology to clinical application[J].Front Physiol,2014,5:455.
[16]Adamsson Eryd S,BornéY,Melander O,et al.Red blood cell Distribution width is associated with incidence of atrial fibrillation[J].J Intern Med,2014,275(1):84-92.
[17]Güngor B,Ozcan KS,Erdinler,et al.Elevated levels of RDW is associated with non-valvular atrial fibrillation[J].J Thromb Thrombolysis,2014,37(4):404-410.
[18]Liu T,Shao Q,Miao S,et al.Red cell distribution width as a novel,inexpensive marker for paroxysmal atrial fibrillation[J].Int J Cardiol,2014,171(2):e52-53.
[19]Gurses KM,Yalcin MU,Kocyigit D,et al.Red blood cell distribution width predicts outcome of cryoballoon-based atrial fibrillation ablation[J].J Interv Card Electrophysiol,2015,42(1):51-58.
[20]Yanagisawa S,Inden Y,Kato H,et al.Elevated red blood cell distribution width predicts recurrence after catheter ablation for atrial fibrillation in patients with heart failure-comparison with nonheart failure patients[J].Circ J,2016,80(3):627-638.
[21]Erta G,Aydin C,Sonmez O,et al.Red cell distribution width predicts new-onset atrial fibrillation after coronary artery bypass grafting[J].Scand Cardiovasc J,2013,47(3):132-135.
[22]Korantzopoulos P,Liu T.RDW as a marker of postoperative atrial fibrillation[J].Int J Cardiol,2015,191:109.
[23]Li HL,Liu T,Xu G,et al.Red blood cell distribution width and the recurrence of atrial fibrillation after ablation in patients with paroxysmal non-valvular symptomatic atrial fibrillation[J].Int JCardiol,2016,203:834-836.
[24]Zhao J,Liu T,Korantzopoulos P,et al.Red blood cell distribution width and left atrial thrombus or spontaneous echo contrast in patients with non-valvular atrial fibrillation[J].Int J Cardiol,2015,180:63-65.
[25]Kurt M,Tangboga IH,Buyukkaya E,et al.Relation of red cell distribution width with CHA2DS2-VASc score in patients with nonvalvular atrial fibrillation[J].Clin Appl Thromb Hemost,2014,20(7):687-692.
[26]Liu T,Shao Q,Korantzopoulos P,et al.Relation of red blood cell distribution width with CHADS2 and CHA2DS2-VASc score in Chinese patients with non-valvular atrial fibrillation[J].Int JCardiol,2017,228:861-864.
[27]Saliba W,Barnett-Griness O,Rennert G.Red cell distribution width and all-cause mortality in patients with atrial fibrillation:Acohort study[J].J Arrhythmia,2017,33(1):56-62.
[28]Wan HB,Yang YM,Zhu J,et al.The relationship between elevated red cell distribution width and long-term outcomes among patients with atrial fibrillation[J].Clin Biochem,2015,48(12):726-767.
[29]Lippi G,Cervellin G.Risk assessment of post-infarction heart failure.Systematic review on the role of emerging biomarkers[J].Crit Rev Clin Lab Sci,2014,51(1):13-29.
[30]Inuzuka R,Abe J.Red blood cell distribution width as a link between ineffective erythropoiesis and chronic inflammation heart failure[J].Circ J,2015,75(5):974-975.
[31]BornéY,Smith JG,Melander O,et al.Red cell distribution width and risk for first hospitalization due to heart failure:A populationbased cohort study[J].Eur J Heart Fail,2011,13(12):1355-1361.
[32]Tanindi A,Topal FE,Topal F,et al.Red cell distribution width in patients with prehypertension and hypertension[J].Blood Press,2012,21(3):177-181.
[33]Huang YL,Hu ZD,Liu SJ,et al.Prognostic value of red blood cell distribution width for patients with heart failure:A systematic review and meta-analysis of cohort studies[J].PLo S One,2014,9(8):e104861.
[34]Pascual-Figal DA,Bonaque JC,Manzano-Fernández S,et al.Red blood cell distribution width predicts newonset anemia in heart failure patients[J].Int J Cardiol,2012,160(3):196-200.
[35]Uemura Y,Shibata R,Takemoto K,et al.Elevation of red blood cell distribution width during hospitalization predicts mortality in patients with acute decompensated heart failure[J].J Cardiol,2016,67(3):268-273.
[36]陈环,吴继雄.心力衰竭患者红细胞分布宽度与心功能的关系及对院内死亡风险的分析[J].实用医学杂志,2011,27(6):1009-1011.
[37]Fukuta H,Ohte N,Mukai S,et al.Elevated plasma levels of B-type natriuretic Peptide but not C-reactive protein are associated with higher red cell distribution width in patients with coronary artery disease[J].Int Heart J,2009,50(3):301-312.
[38]Ozcan F,Turak O,Durak A,et al.Red cell distribution width and inflammation in patients with non-dipper hypertension[J].Blood Press,2013,22(2):80-85.
[39]Fornal M,Wizner B,Cwynar M,et al.Association of red blood cell distribution width,inflammation markers and morphological as well as rheological erythrocyte parameters with target organ damage in hypertension[J].Clin Hemorheol Microcirc,2014,56(4):325-335.
[40]吴轶,柯淑兰,项伟忠,等.不同靶器官损害高血压患者红细胞分布宽度水平变化的研究[J].中国现代医生,2018,56(6):4-8.
[41]Penn A,Mohr AM,Shah SG,et al.Dose-response relationship between norepinephrine and erythropoiesis:Evidence for a critical threshold[J].J Surg Res,2010,163(2):e85-90.
[42]Fici F,Celik T,Balta S,et al.Comparative effects of nebivolol and metoprolol on red cell distribution width and neutrophil/lymphocyte ratio in patients with newly diagnosed essential hypertension[J].J Cardiovasc Pharmacol,2013,62(4):388-393.
[2]陈奕农,胡仁平,汪南田.动脉粥样硬化性脑梗死与红细胞分布宽度相关性研究[J].安徽医学,2016,37(6):743-745.
[3]Ycas JW,Horrow JC,Horne BD.Persistent increase in red cell size distribution width after acute diseases:A biomarker of hypoxemia?[J].Clin Chim Acta,2015,448:107-117.
[4]Lippi G,Mattiuzzi C.The biomarker paradigm:Between diagnostic efficiency and clinical efficacy[J].Pol Arch Med Wewn,2015,125(4):282-288.
[5]LappéJM,Horne BD,Shah SH,et al.Red cell distribution width,C-reactive protein,the complete blood count,and mortality in patients with coronary disease and a normal comparison population[J].Clin Chim Acta,2011,412(23/24):2094-2099.
[6]Patel HH,Patel HR,Higgins JM.Modulation of red blood cell population dynamics is a fundamental homeostatic response to disease[J].Am J Hematol,2015,90(5):422-428.
[7]Lippi G,Filippazzi L,Montagnana M,et al.Clinical usefulness of measuring red blood cell distribution width acute coronary syndromes[J].Clin Chem Lab Med,2009,47(3):353-357.
[8]Nagula P,Karumuri S,Otikunta AN,et al."Correlation of red blood cell distribution width with the severity of coronary artery disease-A single center study"[J].Indian Heart J,2015,69(6):757-761.
[9]Zalawadiya SK,Veeranna V,Niraj A,et al.Red cell distribution width and risk of coronary heart disease events[J].Am J Cardiol,2010,106(7):988-993.
[10]Kara9aglar E,Bal U,HasrcS,et al.Coronary artery disease detected by coronary computed tomography angiography is associated with red cell distribution width[J].Turk Kardiyol Dern Ars,2016,44(7):570-574.
[11]陶波,蒋学俊.红细胞分布宽度与冠心病病变程度的关系.岭南心血管病杂志,2016,22(5):544-548.
[12]Patel KV,Semba RD,Ferrucci L,et al.Red cell distribution width and mortality in older adults:A meta-analysis[J].J Gerontol ABiol Sci Med Sci,2010,65(3):258-265.
[13]Tonelli M,Sacks F,Arnold M,et al.Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease[J].Circulation,2008,117(2):163-168.
[14]Sun XP,Chen WM,Sun ZJ,et al."Impact of red blood cell distribution width on long-term mortality in patients with ST-elevation myocardial infarction"[J].Cardiology,2014,128(4):343-348.
[15]Linden F,Domschke G,Erbel C,et al.Inflammatory therapeutic targets in coronary atheroselerosis-from molecular biology to clinical application[J].Front Physiol,2014,5:455.
[16]Adamsson Eryd S,BornéY,Melander O,et al.Red blood cell Distribution width is associated with incidence of atrial fibrillation[J].J Intern Med,2014,275(1):84-92.
[17]Güngor B,Ozcan KS,Erdinler,et al.Elevated levels of RDW is associated with non-valvular atrial fibrillation[J].J Thromb Thrombolysis,2014,37(4):404-410.
[18]Liu T,Shao Q,Miao S,et al.Red cell distribution width as a novel,inexpensive marker for paroxysmal atrial fibrillation[J].Int J Cardiol,2014,171(2):e52-53.
[19]Gurses KM,Yalcin MU,Kocyigit D,et al.Red blood cell distribution width predicts outcome of cryoballoon-based atrial fibrillation ablation[J].J Interv Card Electrophysiol,2015,42(1):51-58.
[20]Yanagisawa S,Inden Y,Kato H,et al.Elevated red blood cell distribution width predicts recurrence after catheter ablation for atrial fibrillation in patients with heart failure-comparison with nonheart failure patients[J].Circ J,2016,80(3):627-638.
[21]Erta G,Aydin C,Sonmez O,et al.Red cell distribution width predicts new-onset atrial fibrillation after coronary artery bypass grafting[J].Scand Cardiovasc J,2013,47(3):132-135.
[22]Korantzopoulos P,Liu T.RDW as a marker of postoperative atrial fibrillation[J].Int J Cardiol,2015,191:109.
[23]Li HL,Liu T,Xu G,et al.Red blood cell distribution width and the recurrence of atrial fibrillation after ablation in patients with paroxysmal non-valvular symptomatic atrial fibrillation[J].Int JCardiol,2016,203:834-836.
[24]Zhao J,Liu T,Korantzopoulos P,et al.Red blood cell distribution width and left atrial thrombus or spontaneous echo contrast in patients with non-valvular atrial fibrillation[J].Int J Cardiol,2015,180:63-65.
[25]Kurt M,Tangboga IH,Buyukkaya E,et al.Relation of red cell distribution width with CHA2DS2-VASc score in patients with nonvalvular atrial fibrillation[J].Clin Appl Thromb Hemost,2014,20(7):687-692.
[26]Liu T,Shao Q,Korantzopoulos P,et al.Relation of red blood cell distribution width with CHADS2 and CHA2DS2-VASc score in Chinese patients with non-valvular atrial fibrillation[J].Int JCardiol,2017,228:861-864.
[27]Saliba W,Barnett-Griness O,Rennert G.Red cell distribution width and all-cause mortality in patients with atrial fibrillation:Acohort study[J].J Arrhythmia,2017,33(1):56-62.
[28]Wan HB,Yang YM,Zhu J,et al.The relationship between elevated red cell distribution width and long-term outcomes among patients with atrial fibrillation[J].Clin Biochem,2015,48(12):726-767.
[29]Lippi G,Cervellin G.Risk assessment of post-infarction heart failure.Systematic review on the role of emerging biomarkers[J].Crit Rev Clin Lab Sci,2014,51(1):13-29.
[30]Inuzuka R,Abe J.Red blood cell distribution width as a link between ineffective erythropoiesis and chronic inflammation heart failure[J].Circ J,2015,75(5):974-975.
[31]BornéY,Smith JG,Melander O,et al.Red cell distribution width and risk for first hospitalization due to heart failure:A populationbased cohort study[J].Eur J Heart Fail,2011,13(12):1355-1361.
[32]Tanindi A,Topal FE,Topal F,et al.Red cell distribution width in patients with prehypertension and hypertension[J].Blood Press,2012,21(3):177-181.
[33]Huang YL,Hu ZD,Liu SJ,et al.Prognostic value of red blood cell distribution width for patients with heart failure:A systematic review and meta-analysis of cohort studies[J].PLo S One,2014,9(8):e104861.
[34]Pascual-Figal DA,Bonaque JC,Manzano-Fernández S,et al.Red blood cell distribution width predicts newonset anemia in heart failure patients[J].Int J Cardiol,2012,160(3):196-200.
[35]Uemura Y,Shibata R,Takemoto K,et al.Elevation of red blood cell distribution width during hospitalization predicts mortality in patients with acute decompensated heart failure[J].J Cardiol,2016,67(3):268-273.
[36]陈环,吴继雄.心力衰竭患者红细胞分布宽度与心功能的关系及对院内死亡风险的分析[J].实用医学杂志,2011,27(6):1009-1011.
[37]Fukuta H,Ohte N,Mukai S,et al.Elevated plasma levels of B-type natriuretic Peptide but not C-reactive protein are associated with higher red cell distribution width in patients with coronary artery disease[J].Int Heart J,2009,50(3):301-312.
[38]Ozcan F,Turak O,Durak A,et al.Red cell distribution width and inflammation in patients with non-dipper hypertension[J].Blood Press,2013,22(2):80-85.
[39]Fornal M,Wizner B,Cwynar M,et al.Association of red blood cell distribution width,inflammation markers and morphological as well as rheological erythrocyte parameters with target organ damage in hypertension[J].Clin Hemorheol Microcirc,2014,56(4):325-335.
[40]吴轶,柯淑兰,项伟忠,等.不同靶器官损害高血压患者红细胞分布宽度水平变化的研究[J].中国现代医生,2018,56(6):4-8.
[41]Penn A,Mohr AM,Shah SG,et al.Dose-response relationship between norepinephrine and erythropoiesis:Evidence for a critical threshold[J].J Surg Res,2010,163(2):e85-90.
[42]Fici F,Celik T,Balta S,et al.Comparative effects of nebivolol and metoprolol on red cell distribution width and neutrophil/lymphocyte ratio in patients with newly diagnosed essential hypertension[J].J Cardiovasc Pharmacol,2013,62(4):388-393.