Objective:To investigate the relationship between red blood cell distribution width(RDW) and leukoaraiosis(LA) in patients with acute ischemic stroke.Methods:228 cases of acute ischemic stroke admitted to the neurological department of Yijishan Hospital were included between August 2015 and February 2016,and divided into LA group and non-LA group.The general clinical data were recorded and the risk factors were analyzed for LA.The correlation between RDW and LA was assessed with modified Fazekas scale for white matter lesions.The predictive value was verified on the risk factors by receiver operating characteristic (ROC) curve.Results:①LA occurred in 125 of 228 (54.82％) acute ischemic stroke patients;②Univariate analysis showed that age,history of hypertension and the level ofRDW were associated with LA;③Multiple Logistic regression identified age(OR=1.136,95％CI 1.093-1.181,P＜0.001),history of hypertension(OR=3.970,95％CI 1.923-8.198,P＜0.001) and RDW(OR=3.469,95％CI 1.739-6.922,P＜0.001) as being significandy independently associated with the presence of LA;④Spearman rank correlation analysis indicated that RDW was positively correlated with different classification of LA;⑤ROC curve analysis revealed that the optimal cutoff of RDW to predict LA was 12.95％ (AUC =0.780,sensitivity 0.778;specificity 0.860).Conclusion:Advanced RDW is an independent risk factor for LA in acute ischemic stroke and positively correlated with the severity of LA.%目的:探讨红细胞分布宽度(RDW)与急性缺血性脑卒中患者合并脑白质疏松症(LA)的相关性.方法:连续选取2015年8月～2016年2月入住皖南医学院弋矶山医院神经内科228例急性缺血性脑卒中患者,分为LA组和非LA组,记录两组患者一般临床资料,分析LA的相关危险因素,探讨RDW与LA的相关性;采用改良的Fazekas分级标准评价LA病变的严重程度,分析其与RDW的关系,并利用ROC曲线分析RDW对LA的预测价值.结果:①228例急性缺血性脑卒中患者中,125例合并有LA,发病率为54.82％.②单因素分析示,两组间年龄、高血压病和RDW差异有统计学意义(P＜0.05).③多因素Logistic回归分析示,年龄(OR=1.136,95％CI 1.093～1.181,P＜0.001)、高血压病(OR=3.970,95％CI 1.923～ 8.198,P＜0.001)和RDW(OR=3.469,95％CI 1.739～6.922,P＜0.001)是急性缺血性脑卒中合并LA的独立危险因素.④Spearman等级相关分析显示RDW与LA不同分级呈正相关.⑤ROC曲线示,RDW曲线下面积(AUG)为0.780,最佳阈值为12.95％,灵敏度为0.778,特异度为0.860.结论:高水平RDW是急性缺血性脑卒中患者合并LA的独立危险因素,与其严重程度密切相关.
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