红细胞分布宽度对维持性腹膜透析患者心血管疾病的预测价值

Predictive Value of Red Cell Volume Distribution Width for Cardiovascular Disease in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

目的:探讨红细胞分布宽度(red cell volume distribution width,RDW)与维持性腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者心血管疾病(cardiovascular disease,CVD)的相关性.方法:回顾性分析2015年1月-2018年6月中山大学附属东华医院CAPD患者的临床资料,根据RDW取值将患者分为高RDW组与低RDW组,比较两组患者的临床基线资料,采用Spearman相关分析分析RDW与各种指标的相关性,以Kaplan-Meier生存曲线比较两组CVD发生率的差异;利用Cox回归模型分析CVD的危险因素,及ROC曲线分析RDW预测CAPD患者CVD的最佳截值.结果:本研究共纳入124例CAPD患者,其中高RDW组66例(53.2%),低RDW组58例(46.8%).两组Hb、TC、LDL、CRP、Alb、总Kt/V、RRF比较,差异均有统计学意义(P<0.05).高RDW组38例(57.6%)患者发生CVD,低RDW组18例(31.0%)患者发生CVD,两组比较差异有统计学意义(P<0.05).Kaplan-Meier生存曲线显示,两组CVD生存率比较差异有统计学意义(P<0.05);多因素Cox回归分析显示,高RDW、CRP、Alb、RRF、总Kt/V均是CAPD患者CVD的独立危险因素.受试者工作特征曲线(ROC)结果显示,RDW=14.35%是预测CAPD患者CVD发生的最佳截值.结论:高RDW、CRP、Alb、RRF、总Kt/V均是CAPD患者CVD的独立危险因素,RDW对CAPD患者CVD的发生有较高的预测价值.

Objective:To investigate the association of red cell volume distribution width(RDW)for cardiovascular disease(CVD)in patients undergoing continuous ambulatory peritoneal dialysis(CAPD).Method:The clinical data was retrospectively analyzed in patients undergoing CAPD dialysis in Donghua Hospital Affiliated of Sun Yat-sen University from January 2015 and June 2018.Patients were divided into high RDW group and low RDW group according to the value of RDW.The data of two groups were compared and Spearman’s correlation analysis was used to explore the association of RDW with clinical.Survival curves were calculated using Kaplan-Meier method.Cox regression model was employed to analyze risk factors of CVD,and predictive value of RDW for CVD in continuous ambulatory peritoneal dialysis.Result:In this study,124 CAPD patients were enrolled.There were 66 patients(53.2%)in high RDW group and 58 patients(46.8%)in low RDW group.There were statistical differences in hemoglobin(Hb),triglyceride(TC),Low density lipoprotein(LDL),C-reactive protein(CRP),serum albumin(Alb),total Kt/V,residual renal function(RRF)between two groups(P<0.05).CVD occurred in 38 patients(57.6%)in the high RDW group and 18 patients(31.0%)in the low RDW group,there was statistical significance(P<0.05).Kaplan-Meier survival curves showed that CVD survival rate between two groups was significant difference(P<0.05).Multivariate Cox regression analysis showed that high RDW,CRP,Alb,RRF and total Kt/V were independent risk factors for CVD in CAPD patients.Receiver operating chracteristic curve(ROC)showed that RDW=14.35%was the best cut-off point for predicting CVD in CAPD patients.Conclusion:RDW,CRP,Alb,RRF and total Kt/V are associated with CVD risks in CAPD patients,and it can be stratified as a valuable indicator for the risk of CVD.