红细胞分布宽度β_(2)-微球蛋白与维持性血液透析患者认知障碍的相关性研究

Correlation of red blood cell distribution width,β_2-microglobulin and cognitive impairment in patients undergoing maintenance hemodialysis

目的 探讨红细胞分布宽度(RDW)、β_(2)-微球蛋白(β_(2)-MG)与维持性血液透析(MHD)患者认知障碍(CI)之间的关系。方法 收集2022年1月至6月于山西医科大学第三医院血液净化中心MHD患者195例临床及实验室资料,进行简易智力状态检查量表筛查。Logistic回归分析MHD患者发生CI的危险因素、受试者工作特征(ROC)曲线分析RDW、β_(2)-MG对MHD患者CI预测价值。结果 195例MHD患者中CI71例(36.4%)。Logistic回归分析显示RDW、β_(2)-MG是MHD患者发生CI的独立危险因素。RDW预测MHD认知功能障碍的灵敏度80.3%、特异度为83.1%,曲线下面积(95%CI)为0.856(0.803,0.909)(P<0.05)。β_(2)-MG预测MHD患者认知功能障碍的灵敏度87.3%、特异度为78.2%,曲线下面积(95%CI)为0.872(0.821,0.922)(P<0.05)。RDW联合β_(2)-MG预测MHD认知功能障碍灵敏度85.9%、特异度为88.0%,曲线下面积(95%CI)为0.949(0.922,0.975)(P<0.05)。结论 高RDW、β_(2)-MG对MHD患者认知障碍有一定预测价值,且两者联合检测对MHD患者认知障碍预测价值更高。

Objective To investigate the relationship between red cell distribution width (RDW),β_2-microglobulin (MG),and maintenance hemodialysis (MHD),as well as cognitive impairment (CI) in MHD patients.Methods Clinical and laboratory data of 195 MHD patients in blood purification center of the Third Hospital of Shanxi Medical University from January 2022 to June 2022 were collected and screened with simple mental state checklist.Logistic regression was used to analyze the risk factors for CI in MHD patients,and the receiver operating curve (ROC curve) was used to examine the predictive value of RDW and β_2-MG for CI in MHD patients.Results In our institution,there were 71 cases of CI among 195 MHD patients,with a prevalence rate of 36.4%.RDW and β_2-MG were found to be independent risk variables for CI in MHD patients using logistic regression analysis.RDW predicted CI in MHD with a sensitivity of 80.3%,specificity of 83.1%,and area under the curve 95%CI was 0.856(0.803,0.909),(P<0.05).The sensitivity and specificity of β_2-MG in predicting CI in MHD patients were 87.3%and 78.2%,respectively,and the area under the curve 95%CI was 0.872(0.821,0.922)(P<0.05).RDW in conjunction with β_2-MG was projected to have a sensitivity of 85.9%,specificity of 88%,and area under the curve 95%CI was 0.949(0.922,0.975)(P<0.05).Conclusion High RDW and β_2-MG have certain predictive value for cognitive impairment in MHD patients,and the combined detection of RDW and β_2-MG has higher predictive value for cognitive impairment in MHD patients.