血液透析患者心血管事件与红细胞分布宽度的相关性研究

Correlation of cardiovascular events and of RBC distribution width in hemodialysis patients

目的探讨红细胞分布宽度(RDW)与血液透析患者透析时发生心血管事件的相关性。方法回顾性选取2018年1月至2021年4月山东中医药大学附属医院血液透析科收治的275例患者为研究对象,依据RDW异常与否分为RDW正常组和升高组,分析两组患者发生心血管事件的比例;根据患者在透析期间是否发生心血管事件分为发病组和未发病组,比较两组患者的RDW。收集患者一般资料和实验室相关数据,探讨RDW等数据与心血管事件的相关性,分析RDW与其他数据的相互关系,评价RDW对心血管事件的预测价值。结果RDW升高组患者心血管事件发生率为75.4%,高于RDW正常组患者的17.0%,差异有统计学意义(P<0.05);发病组患者RDW为(15.27±1.97)%,高于未发病组患者的RDW[(13.26±0.88)%],差异有统计学意义(P<0.05);发病组和未发病组患者在透析龄、清蛋白、RDW、Hb、MCV、hs-CRP、BNP、铁蛋白等指标之间差异有统计学意义(P<0.05),在性别、年龄、三酰甘油、前清蛋白、血清钙、WBC等指标之间差异无统计学意义(P>0.05);Pearson相关分析显示,RDW与hs-CRP、BNP、尿素氮、肌酐、透析龄呈正相关(r>0,P<0.05),与Hb、清蛋白等呈负相关(r<0,P<0.05);受试者工作特征(ROC)曲线显示,RDW预测血液透析患者发生心血管事件的曲线下面积(AUC)为0.839,95%CI:0.778~0.901。结论RDW异常升高是血液透析患者发生心血管事件的重要危险指标,具有良好的预测价值,临床上应予以重视。

Objective To explore the correlation between red blood cell distribution width(RDW)and the cardiovascular events occurrence during dialysis in the patients with hemodialysis.Methods A total of 275 patients treated in the hemodialysis department of this hospital from January 2018 to April 2021 were retrospectively selected as the study subjects and divided into the RDW normal group and RDW elevation group according to whether RDW having abnormalities.The incidence rates of cardiovascular evens in the two groups were analyzed.The patients were divided into the onset group and non-onset group according to whether the cardiovascular events occurring during the hemodialysis period.RDW was compared between the two groups.The general data of the patients and laboratory-related data were collected.The correlation between the data such as RDW and cardiovascular events was analyzed.The mutual relation between RDW and other data was analyzed.The predictive value of RDW in cardiovascular events was evaluated.Results The incidence rate of cardiovascular events in the RDW elevation group was 75.4%,which was higher than 17.0%in the RDW normal group,and the difference was statistically significant(P<0.05);RDW in onset group was(15.27±1.97)%,which was higher than(13.26±0.88)%in non-onset group,and the difference was statistically significant(P<0.05);the differences in the hemodialysis age,albumin,RDW,Hb,MCV,hs-CRP,BNP and ferritin had statistical differences between the onset group and non-onset group(P<0.05),the differences in the indicators of the sex,age,TG,prealbumin,serum Ca and WBC had no statistical significance(P>0.05);the Pearson correlation analysis showed that RDW was positively correlated with hs-CRP,BNP,BUN,Cr and hemodialysis age(r>0,P<0.05),and negatively correlated with Hb,Alb(r<0,P<0.05);the receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of RDW for predicting the cardiovascular events occurrence was 0.839 and 95%CI was 0.778-0.901.Conclusion Abnormal elevation of RDW is an important risk index for cardiovascular events occurrence in hemodialysis patients,which has good predictive value and should be paid enough attention in clinic.