摘要
目的研究红细胞分布宽度（RDW）与透析患者左心室肥厚（LVH）的相关性。方法回顾性分析2016年4月-2017年11月在南京医科大学附属逸夫医院血液净化中心行维持性血液透析（MHD）治疗≥3个月、年龄≥18岁的终末期肾病（ESRD）患者的资料，包括一般资料、合并疾病以及用药情况、各项实验室检测结果（包括血常规、肾功能、血脂功能、凝血功能等），心脏结构及功能采用心脏彩超测量，以左心室质量指数（LVMI）评价心肌肥厚程度。剔除资料不全者后共136例患者入选，根据RDW正常范围的界值（16％）分为RDW〈16％组（n=67）和RDW≥16％组（n=69）。结果RDW与透析患者LVMI呈正相关（r=0．62，P〈0．01）。RDW≥16％的患者与LVMI的相关性比RDW〈16％的患者更强（RDW〈16％组r=0．025，P=0．067；RDW≥16％组r=0．398。P=0．001）。多重线性回归分析显示：排除年龄、收缩压、舒张压、总胆固醇、甘油三酯等相关因素后，RDW仍与LVMI成正相关（t=8．804，P=0．00）。结论RDW是透析患者左心室肥厚的独立危险因素，RDW≥16％的透析患者心肌肥厚的程度更明显。
Objective To explore the relationship between red cell distribution width （RDW） and left ventricular hypertrophy （LVH） in dialysis patients. Methods We retrospectively analyzed the clinical data from patient （aging more than 18 years） receiving maintained hemodialysis （MHD） for more than three months in Sir Run Run Hospital of Nanjing Medical University from April 2016 to October 2017. The data included general information, combined diseases, medication use, laboratory examination, cardiac structure and function. The myocardial thickness was evaluated by left ventricular hypertrophy index （LVHI）. Then, a total of 136 patients were enrolled and divided into two groups： a normal RDW group （RDW 〈 16%, n = 67） and an elevated RDW group （RDW ≥16%, n = 69） based on the normal RDW limit of 16.0%. Results The RDW is positively related to LVHI in dialysis patients （ r = 0. 62, P 〈 0.01 ）. Compared with the normal RDW group, remarkably closer relationship was found in the elevated RDW group （ RDW 〈 16%, r = 0. 025, P = 0.067 ; RDW ≥ 16%, r = 0. 398, P = 0. 001 ）. According to multiline linear regression analysis, RDW remained positively associated with left ventrlcular thickness when the effects of age, blood pressure, total cholesterol, triglyceride and other related factors were excluded. Conclusions RDW is an independent risk factor for LVH in hemodi- alysis patients, which is more obvious in those with ≥ 16% RDW.
作者
孙晴
嵇小兵
万辛
曹长春
SUN Qing1, JI Xiaobing2, WAN Xin2, CAO Changchun1(1. Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu 221002, China; 2. Department of Nephrology, The First Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 21000)
出处
《徐州医科大学学报》
CAS
2018年第2期89-93,共5页
Journal of Xuzhou Medical University
基金
国家自然科学基金（81370797）
江苏省临床医学科技专项（BL2014015）
关键词
红细胞分布宽度
终末期肾病
维持性血液透析
左心室肥厚
red cell distribution width
end stage renal disease
maintained hemodialysis
left ventricular hypertrophy
