Correlation Between Red Blood Cell Distribution Width And The Acute Cerebral Infarction

Background and Objective: Red blood cell distribution width(RDW)is an index of the heterogeneity of erythrocyte volume in peripheral blood,and it is mainly used in the diagnosis and differential diagnosis of anemia.Recent years,with the progress of the medical science,RDW has been confirmed associated with cardiovascular disease,chronic obstructive pulmonary disease,peripheral arterial disease,kidney damage,and cancer.RDW has been considered a potent marker for the prognosis of many diseases,especially cardiovascular disease.However,cerebrovascular diseases and cardiovascular diseases have similar pathophysiological basis.Therefore,the purpose of this study is to explore the correlation between RDW and the onset risk of acute cerebral infarction,and to further analyze the predictive value of RDW for the short-term prognosis of acute cerebral infarction patients.Methods: A total of 169 cases of acute cerebral infarction diagnosed at admission in the Department of Neurology,the Fifth Affiliated Hospital of Zhengzhou University,from January 2016 to March 2017,were enrolled retrospectively as case group.And 100 cases of non stroke patients were collected in the same Department during the same period as the control group.The demographic characteristics,clinical data and RDW were collected and compared.Multivariate logistic regression analysis was used to analyze the risk factors of acute cerebral infarction.The cases group was divided into ether a good prognosis group(n=104)or a poor prognosis group(n=65)according to the scoring criteria of the modified Rankin scale(m RS).The demographic characteristics,clinical datas and RDW were compared.Multivariate logistic regression analysis was used to analyze the risk factors of poor prognosis of acute cerebral infarction.Receiver operating characteristic curve(ROC)was used to evaluate the predictive value of the RDW level for patients with acute cerebral infarction on admission.Results:(1)Compared with the non stroke group,the level of RDW in the acute cerebral infarction group was higher,and the difference between the groups was statistically significant [13.7%(130%,15.35%)vs 13.2%(12.325%,14.675%),P<0.05].Age,hypertension and coronary heart disease accounted for a higher proportion.The difference was statistically significant in age,hypertension and coronary heart disease incidence(all P<0.05).There was no significant difference in other indexes between the groups(all P>0.05).(2)After adjustment for the influence of age,hypertension and coronary heart disease,the level RDW(OR=1.616,95%CI: 1.224-2.132,P<0.05)was an independent risk factor for cerebral infarction.(3)Compared with the good prognosis group,the level of RDW in the poor prognosis group was higher [14.2%(13.5%,15.6%)vs 13.5%(12.7%,14.7%),P<0.05].NIHSS score on admission,incidence of Diabetic history and hyperlipidemia history were significantly higher as well(all P<0.05).(4)After adjustment for the influence of NIHSS score,diabetes and hyperlipidemia,the level RDW on admission(OR=1.629,95%CI: 1.052-2.521,P<0.05)was an independent risk factor for poor prognosis.(5)ROC curve analysis showed that the diagnostic cut-off value of the RDW level on admission for poor prognosis in patients with acute ischemic stroke was 13.65%.Its sensitivity was 70.8% and specificity was 60.6%.Conclusions:(1)High level of RDW may be an independent risk factor for cerebral infarction.(2)On admission,the level of RDW can reflect the prognosis of acute cerebral infarction.The higher the level of RDW,the greater the risk of poor prognosis.