Objective To explore the relationship between red cell distribution width ( RDW) and the sever-ity of disease in patients with acute exacerbated chronic obstructive pulmonary disease ( AECOPD ) . Methods A study was performed by investigating the clinical data in 140 patients with AECOPD, who were admitted to our medi-cal department. They were divided into two groups according to their RDW levels, and the differences of correlated in-dex such as the score of CAT , the LOS and the level of BNP ,CRP, WBC, PaO2 , PaCO2 , the incidence of respira-tory failure and right heart failure were compared and analyzed between the two groups. They were divided into 4 groups according to their complications, and RDW was compared and analyzed among those groups. Results The score of CAT, LOS and the level of BNP, CRP, WBC and PaCO2 in patients with an elevated RDW all increased compared with those patients with a non-elevated RDW, and the level of PaO2 decreased more significantly than those patients with a non-elevated RDW (P<0. 05). The incidence of respiratory failure and right heart failure in patients with an elevated RDW were higher than those with a non-elevated RDW (P<0. 001). RDW in patients with respira-tory failure only, right heart failure only and with both respiratory failure and right heart failure were all higher than that in patients without respiratory failure and right heart failure ( P <0. 001 ) . RDW level in AECOPD patients showed negative correlation with PaO2 , and positive correlation with WBC, CRP, PaCO2 , BNP, the score of CAT and LOS (P<0. 05). Conclusion RDW can be used as a biomarker for evaluating the severity of disease in pa-tients with AECOPD.%目的：探讨红细胞体积分布宽度( RDW)与慢性阻塞性肺疾病急性加重( AECOPD)患者病情严重程度的相关性。方法收集我科收治的140例AECOPD患者1的临床资料,根据RDW是否增高分为RDW增高组和RDW正常组；比较CAT分值、住院时间( LOS)、脑钠肽( BNP)、CRP、白细胞计数、PaCO2、PaO2、呼吸衰竭及右心衰竭发生率等相关指标在各组间的差异。根据是否合并呼吸衰竭、右心衰竭分为；既无呼衰又无右心衰( A)组、单纯呼衰( B)组、单纯右心衰( C)组、既有呼衰又有右心衰( D)组,比较RDW值在各组间的差异。结果 RDW增高组CAT分值、住院时间( LOS)、脑钠肽( BNP)、PaCO2、CRP、白细胞计数均高于RDW正常组(P<0．05),PaO2低于RDW正常组(P<0．05)。 RDW增高组呼吸衰竭、右心衰竭发生率显著高于RDW正常组(P<0．001)。 B、C、D组RDW值均显著高于A组(P<0．05)。 RDW值与PaO2呈负相关,与白细胞计数、CRP、PaCO2、BNP、CAT分值、LOS均呈正相关(P<0．05)。结论 RDW或许可作为评估AECOPD患者病情严重程度的一项重要参考指标。
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