红细胞分布宽度与缺血性卒中相关性研究进展

doi:10.3969/j.issn.1673-5765.2018.07.021

摘要/Abstract

摘要：

红细胞分布宽度（red blood cell distribution width，RDW）是反映红细胞体积分布离散度的指标，其升高主要见于各种类型的贫血。近年来，越来越多的研究着力于探究RDW与心脑血管疾病之间的相关性，国内外多项研究结果表明，RDW与心血管疾病及急性缺血性卒中（acute ischemic stroke， AIS）之间有一定的相关性，不仅可用于辅助预测AIS发病率，还可辅助评估AIS患者的病情严重程度并预测患者的预后。本文就RDW与AIS的发病、病情严重程度及预后等之间的关系进行综述。

文章导读： 通过回顾复习相关文献，了解红细胞分布宽度与缺血性卒中发病、病情进展及功能预后之间的关系以及两者间相关性的机制，为找到一个简单、高敏感及独立的生物指标预测卒中提供证据。

关键词: 红细胞分布宽度; 急性缺血性卒中; 颈动脉粥样硬化; 生物学机制

Abstract:

Red blood cell distribution width (RDW) is an index reflecting the heterogeneity of erythrocyte volume distribution, which is closely related to various kinds of anemia. In recent years, more and more studies have revealed that RDW is related to cardiovascular diseases and stroke. It can help to predict the probability of AIS, assess the severity of patients with acute ischemic stroke (AIS) and predict their prognosis. This article reviews the relationship between RDW and AIS in the terms of incidence, severity of illness, and prognosis.

Key words: Red blood cell distribution width; Acute ischemic stroke; Carotid artery atherosclerosis; Biological mechanism

张星, 陈玮琪, 王拥军. 红细胞分布宽度与缺血性卒中相关性研究进展[J]. 中国卒中杂志, 2018, 13(07): 753-758.

ZHANG Xing, CHEN Wei-Qi, WANG Yong-Jun. Progress of Association between Red Blood Cell Distribution Width and Ischemic Stroke[J]. Chinese Journal of Stroke, 2018, 13(07): 753-758.

参考文献

[1] LIPPI G，PLEBANI M. Red blood cell distribution

width（RDW）and human pathology. One size fits

all[J]. Clin Chem Lab Med，2014，52（9）：1247-

1249.

[2] SULTANA G S，HAQUE S A，SULTANA T，et al.

Value of red cell distribution width（RDW）and RBC

indices in the detection of iron deficiency anemia[J].

Mymensingh Med J，2013，22（2）：370-376.

[3] SAHLI C A，BIBI A，OUALI F，et al. Red cell

indices：differentiation between beta-thalassemia

trait and iron deficiency anemia and application to

sickle cell disease and sickle cell thalassemia[J]. Clin

Chem Lab Med，2013，51（8）：1595-1603.

[4] FELKER G M，ALLEN L A，POCOCK S J，et al.

Red cell distribution width as a novel prognostic

marker in heart failure：data from the CHARM

Program and the Duke Databank[J]. J Am Coll

Cardiol，2007，50（1）：40-47.

[5] XI Q，WANG Y，LIU Z，et al. Red cell distribution

width predicts chronic thromboembolic pulmonary

hypertension in patients with acute pulmonary

embolism in a long-term follow-up[J/OL]. Clin Chem

Lab Med，2014，52（9）：e191-e195. https：//doi.

org/10.1515/cclm-2014-0092.

[6] YANG T，SUN Y J，XIONG C M，et al. Red blood

cell distribution width predicts survival in patients

with Eisenmenger syndrome[J]. Clin Chem Lab Med，

2014，52（5）：743-750.

[7] FORHECZ Z，GOMBOS T，BORGULYA G，et

al. Red cell distribution width in heart failure：

prediction of clinical events and relationship with

markers of ineffective erythropoiesis，inflammation，

renal function，and nutritional state[J]. Am Heart J，

2009，158（4）：659-666.

[8] GRANT B J，KUDALKAR D P，MUTI P，et al.

Relation between lung function and RBC distribution

width in a population-based study[J]. Chest，2003，

124（2）：494-500.

[9] DANESE E，LIPPI G，MONTAGNANA

M. Red blood cell distribution width and

cardiovascular diseases[J/OL]. J Thorac Dis，

2015，7（10）：E402-411. https：//doi.org/10.3978/

j.issn.2072-1439.2015.10.04.

[10] RODRIGUEZ-CARRIO J，ALPERI-LOPEZ

M，LOPEZ P，et al. Red cell distribution width is associated with cardiovascular risk and disease parameters in rheumatoid arthritis[J]. Rheumatology

（Oxford），2015，54（4）：641-646.

[11] 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.

[12] LIPPI G，TARGHER G，MONTAGNANA M，et al.

Relation between red blood cell distribution width

and inflammatory biomarkers in a large cohort of

unselected outpatients[J]. Arch Pathol Lab Med，

2009，133（4）：628-632.

[13] KAYA A，ISIK T，KAYA Y，et al. Relationship

between red cell distribution width and stroke

in patients with stable chronic heart failure：a

propensity score matching analysis[J]. Clin Appl

Thromb Hemost，2015，21（2）：160-165.

[14] WANG W，JIANG B，SUN H，et al. Prevalence，

Incidence，and Mortality of Stroke in China：Results

from a Nationwide Population-Based Survey of 480

687 Adults[J]. Circulation，2017，135（8）：759-771.

[15] DEMIR R，SARITEMUR M，ATIS O，et al. Can

we distinguish stroke and stroke mimics via red cell

distribution width in young patients?[J]. Arch Med

Sci，2015，11（5）：958-963.

[16] ANI C，OVBIAGELE B. Elevated red blood cell

distribution width predicts mortality in persons

with known stroke[J]. J Neurol Sci，2009，277（1-2）：

103-108.

[17] KIM J，KIM Y D，SONG T J，et al. Red blood cell

distribution width is associated with poor clinical

outcome in acute cerebral infarction[J]. Thromb

Haemost，2012，108（2）：349-356.

[18] LAPPEGARD J，ELLINGSEN T S，

SKJELBAKKEN T，et al. Red cell distribution

width is associated with future risk of incident stroke.

The Tromso Study[J]. Thromb Haemost，2016，115

（1）：126-134.

[19] KARA H，DEGIRMENCI S，BAYIR A，et

al. Red cell distribution width and neurological

scoring systems in acute stroke patients[J/OL].

Neuropsychiatr Dis Treat，2015，11：733-739. https：

//doi.org/10.2147/NDT.S81525.

[20] TURCATO G，CAPPELLARI M，FOLLADOR

L，et al. Red Blood Cell Distribution Width Is

an Independent Predictor of Outcome in Patients

Undergoing Thrombolysis for Ischemic Stroke[J].

Semin Thromb Hemost，2017，43（1）：30-35.

[21] FURLAN A J. Time Is Brain[J]. Stroke，2006，37

（12）：2863-2864.

[22] LEIGH R，KRAKAUER J W. MRI-guided selection

of patients for treatment of acute ischemic stroke[J].

Curr Opin Neurol，2014，27（4）：425-433.

[23] LOVBLAD K O，ALTRICHTER S，MENDES

PEREIRA V，et al. Imaging of acute stroke：CT and/

or MRI[J]. J Neuroradiol，2015，42（1）：55-64.

[24] JENSEN M B，CHACON M R，SATTIN J A，et al.

Potential biomarkers for the diagnosis of stroke[J].

Expert Rev Cardiovasc Ther，2009，7（4）：389-393.

[25] HOFFMANN J J，NABBE K C，VAN DEN BROEK

NM. Effect of age and gender on reference intervals

of red blood cell distribution width（RDW）and

mean red cell volume（MCV）[J]. Clin Chem Lab

Med，2015，53（12）：2015-2019.

[26] 张彪，邱一真，陈晓琪，等. 红细胞分布宽度与D-二

聚体在缺血性脑卒中的诊断价值[J]. 中国实用神经

疾病杂志，2016，19（6）：93.

[27] SODERHOLM M，BORNE Y，HEDBLAD B，et al.

Red cell distribution width in relation to incidence

of stroke and carotid atherosclerosis：a populationbased

cohort study[J/OL]. PLoS One，2015，10

（5）：e0124957. https：//doi.org/10.1371/journal.

pone.0124957.

[28] SALIBA W，BARNETT-GRINESS O，ELIAS M，

et al. The association between red cell distribution

width and stroke in patients with atrial fibrillation[J/

OL]. Am J Med，2015，128（2）：192. e11-e18. https：

//doi.org/10.1016/j.amjmed.2014.09.020.

[29] LEE K H，PARK H W，CHO J G，et al. Red cell

distribution width as a novel predictor for clinical

outcomes in patients with paroxysmal atrial

fibrillation[J/OL]. Europace，2015，Suppl 2：ii83-

ii88. https：//doi.org/10.1093/europace/euv210.

[30] VAYA A，HERNANDEZ V，RIVERA L，et al.

Red blood cell distribution width in patients with

cryptogenic stroke[J]. Clin Appl Thromb Hemost，

2015，21（3）：241-245.

[31] CHEN P H，GAO S，WANG Y J，et al. Classifying

Ischemic Stroke，from TOAST to CISS[J]. CNS

Neurosci Ther，2012，18（6）：452-456.

[32] JIA H，LI H，ZHANG Y，et al. Association between

red blood cell distribution width（RDW）and carotid

artery atherosclerosis（CAS）in patients with

primary ischemic stroke[J]. Arch Gerontol Geriatr，

2015，61（1）：72-75.

[33] SELWANESS M，HAMEETEMAN R，VAN

'T KLOOSTER R，et al. Determinants of

carotid atherosclerotic plaque burden in a

stroke-free population[J/OL]. Atherosclerosis，

2016，255：186-192. https：//doi.org/10.1016/

j.atherosclerosis.2016.10.030.

[34] GUPTA A，BARADARAN H，SCHWEITZER A D，et al. Carotid plaque MRI and stroke risk：a

systematic review and meta-analysis[J]. Stroke，2013，

44（11）：3071-3077.

[35] ALMER G，FRASCIONE D，PALI-SCHOLL I，et

al. Interleukin-10：an anti-inflammatory marker

to target atherosclerotic lesions via PEGylated

liposomes[J]. Mol Pharm，2013，10（1）：175-186.

[36] FURER A，FINKELSTEIN A，HALKIN A，et al.

High red blood cell distribution width and preclinical

carotid atherosclerosis[J]. Biomarkers，2015，20（6-

7）：376-381.

[37] 庞荣，李东芳. 红细胞分布宽度与脑梗死患者颈动脉

粥样硬化的相关性研究[J]. 中国保健营养，2014，3

（中）：1254.

[38] FU Y，MAO Y，CHEN S，et al. A Novel

Inflammation- and Nutrition-Based Prognostic

System for Patients with Laryngeal Squamous

Cell Carcinoma：Combination of Red Blood Cell

Distribution Width and Body Mass Index（COR-BMI）

[J/OL]. PLoS One，2016，11（9）：e0163282. https：//

doi.org/10.1371/journal.pone.0163282.

[39] WOHNER N，SOTONYI P，MACHOVICH R，et

al. Lytic resistance of fibrin containing red blood

cells[J]. Arterioscler Thromb Vasc Biol，2011，31

（10）：2306-2313.

[40] MANNUCCI P M. Red cells playing as activated

platelets in thalassemia intermedia[J]. J Thromb

Haemost，2010，8（10）：2149-2451.

[41] YEDGAR S，KOSHKARYEV A，BARSHTEIN

G. The red blood cell in vascular occlusion[J].

Pathophysiol Haemost Thromb，2002，32（5-6）：

263-268.