持续非卧床腹膜透析患者红细胞分布宽度的相关影响因素分析

Analysis of factors influencing red cell distribution width in continuous ambulatory peritoneal dialysis patients

目的探讨持续非卧床腹膜透析(CAPD)患者红细胞分布宽度(RDW)的相关影响因素。方法回顾性分析2019年10月至2020年5月上海健康医学院附属嘉定区中心医院的CAPD患者的临床资料,根据患者的RDW中位数分为低RDW组(RDW≤14.05%,n=52)和高RDW组(RDW>14.05%,n=52),比较2组患者人口统计学、生化及腹膜透析相关指标,采用多元线性回归分析CAPD患者RDW的独立相关因素。结果共入选104例患者,RDW为14.05(13.10,14.80)%,其中男性61例(58.7%),年龄(66.42±8.72)岁,腹膜透析龄32.65(15.71,57.73)个月。高RDW组患者年龄、红细胞生成刺激因子抵抗指数(EHRI)、白细胞介素-6(IL-6)、容量负荷(OH)分别为(68.28±8.57)岁、1.35IU、(35.57±7.12)ng/L、(3.77±0.88)L,显著高于低RDW组患者[(64.57±8.53)岁、0.86 IU、(31.21±7.98)ng/L、(3.20±1.01)L],血清白蛋白[32.00(30.25,34.75)g/L]显著低于低RDW组患者[35.00(33.00,36.75)g/L],差异均有统计学意义(P<0.05)。Spearman相关性分析结果显示,CAPD患者RDW与年龄(r=0.226,P=0.021)、EHRI(r=0.270,P=0.006)、IL-6(r=0.239,P=0.015)、OH(r=0.321,P=0.001)呈正相关,与血清白蛋白呈负相关(r=-0.215,P=0.028)。多元线性回归分析显示,EHRI(β=0.290,P=0.006)和IL-6(β=0.241,P=0.012)是CAPD患者RDW升高的独立相关因素。结论CAPD患者RDW升高与年龄、EHRI、IL-6、OH、血清白蛋白等多项指标有关,EHRI、IL-6是CAPD患者RDW升高的独立相关因素。

Objective To evaluate the associated factors of red cell distribution width(RDW) in continuous ambulatory peritoneal dialysis(CAPD) patients. Methods CAPD patients were recruited from Jiading District Central Hospital Affiliated Shanghai University of Medicine &Health Sciences between October 2019 and May 2020. According to the median RDW,the patients were divided into low RDW group(RDW≤14. 05%,n = 52) and high RDW group(RDW > 14. 05%,n = 52). Demographic data,biochemical parameters and indicators of peritoneal dialysis were compared between the two groups. Multivariate linear regression was used to analyze the associated factors of RDW. Results A total of104 CAPD patients(mean age 66. 42 ± 8. 72 years) with median PD duration 32. 65(15. 71,57. 73) months and median RDW 14. 05(13. 10,14. 80) % were enrolled in this study. Among all the CAPD patients,61(58. 7%) of them were male. In the high RDW group,the age,erythropoiesis stimulating factor resistance index(EHRI),interleukin 6(IL-6),and volume load(OH) were(68. 28 ± 8. 57) years old,1. 35 IU,and(35. 57 ± 7. 12) ng/L,(3. 77 ± 0. 88) L,significantly higher than the low RDW group of patients [(64. 57 ± 8. 53) years old,0. 86 IU,(31. 21 ± 7. 98) ng/L,(3. 20 ± 1. 01) L],serum albumin[32. 00(30. 25,34. 75) g/L]was significantly lower than the low RDW group[35. 00(33. 00,36. 75) g/L) ],the differences were statistically significant(P < 0. 05). Spearman’s rank correlation coefficient showed that RDW was positively correlated with age(r = 0. 226,P = 0. 021),EHRI(r = 0. 270,P = 0. 006),IL-6(r = 0. 239,P = 0. 015) and OH(r = 0. 321,P = 0. 001). RDW was negatively correlated with serum albumin(r =-0. 215,P = 0. 028). Multivariate linear regression showed that IL-6(β = 0. 241,P = 0. 012) and EHRI(β =0. 290,P =0. 006) were independent associated factors of RDW in CAPD patients. Conclusion RDW was associated with age,EHRI,IL-6,OH and serum albumin in CAPD patients,IL-6 and EHRI were independent associated factors of RDW.