红细胞体积分布宽度对维持性血液透析患者心血管事件预测作用

Prediction value of red cell distribution width in the cardiovascular events of maintenance hemodialysis patients

目的观察红细胞体积分布宽度对维持性血液透析患者心血管事件的预测作用。方法选取2018年4月至2019年3月首都医科大学附属北京同仁医院西区血液透析中心行维持性血液透析患者76例作为研究对象,根据透析期间是否发生心血管事件分为心血管事件组(21例)和非心血管事件组(55例)。记录两组患者心血管事件和外周血红细胞体积分布宽度(RDW),采用独立样本t检验,探讨心血管事件和RDW、血红蛋白、年龄、性别、总胆固醇、低密度脂白蛋白、血磷、血钙、甲状旁腺激素等之间的关系。采用多因素logistic回归分析心血管事件的独立影响因素。绘制受试者工作特征(ROC)曲线,评价RDW对心血管事件的诊断价值。结果两组患者在在性别、年龄、血清白蛋白、血肌酐、C反应蛋白(CRP)、RDW、血红蛋白、透前收缩压和B型钠尿肽(BNP)等方面差异有统计学意义(P<0.05)。多因素logistic回归分析显示:收缩压(SBP)、BNP对数及RDW是心血管事件的独立危险因素(P<0.05),ROC曲线显示,曲线下面积AUC为0.771,95%CI为0.645~0.897。结论RDW升高是心血管事件的重要危险因素,具有较好的预测价值。

Objective To observe the relationship between red cell distribution width(RDW)and cardiovascular events in patients undergoing maintenance hemodialysis(MHD).Methods A retrospective analysis was performed in patients who underwent MHD from April 2018 to March 2019 in the hemodialysis center of west campus in Beijing Tongren Hospital Capital Medical University.76 patients were enrolled,which were divided into two groups according to the currency of cardiovascular events.Basic data on demographic dialysis and laboratory were collected.Independent sample T test was used to compare the difference of parameter of demographic,dialysis and laboratory between two groups.Logistic regression analysis was used to analyze the risk factors of cardiovascular events.The receiver operating characteristic curve(ROC curve)was obtained to evaluate the diagnostic value of RDW for cardiovascular events were considered to be statistically significant.Results There were significant differences in gender,age,albumin,RDW,serum creatinine,hemoglobin,CRP,systolic blood pressure and BNP between the two groups.SBP,BNP and RDW were the independent risk factors for cardiovascular events.ROC curve showed,RDW had a predictive effect for cardiovascular events(AUC:0.771,95%CI:0.645-0.897).Conclusion The increase of RDW is an important risk factor as well as a better predictive index for cardiovascular events.