维持性血液透析患者红细胞分布宽度与微炎症状态及心血管不良事件相关性  

Correlation analysis of red blood cell distribution width with micro inflammatory state and cardiovascular adverse events in maintenance hemodialysis patients

作　　者：潘丹 邱明生 郑栓 陈运转[3] PAN Dan;QIU Mingsheng;ZHENG Shuan;CHEN Yunzhuan(Department of Nephrology,Queshan County People's Hospital,Queshan,Henan,China,463200;De-partment of Nephrology,Zhumadian first people's Hospital,Zhumadian,Henan,China,463000;Depart-ment of Nephrology,Zhengzhou first people's Hospital,Zhengzhou,Henan,China,450000)

机构地区：[1]确山县人民医院肾病学科,河南确山463200 [2]驻马店市第一人民医院肾内科,河南驻马店463000 [3]郑州市第一人民医院肾内科,河南郑州450000

出　　处：《分子诊断与治疗杂志》2022年第6期924-927,932,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划项目(LHGJ20191036)。

摘　　要：目的 探讨维持性血液透析患者红细胞分布宽度(RDW)与微炎症状态及心血管不良事件的关系。方法 选择2019年1月至2021年4月本院424例维持性血液透析患者,对患者追踪随访6个月,按患者是否发生心血管不良事件分为不良事件组(n=71)和对照组(n=353),比较两组红细胞参数及CRP水平差异,采用Logistic相关分析维持性血液透析患者发生心血管不良事件的危险因素,分析RDW与CRP的相关关系,绘制ROC曲线分析RDW及CRP对维持性血液透析患者心血管不良事件的预测价值。结果 不良事件组RBC、Hb、Hct、MHC低于对照组,差异有统计学意义(P<0.05),MCV、RDW及CRP高于对照组,差异有统计学意义(P<0.05),Logistic回归分析显示RDW及CRP是维持性血液透析患者发生心血管不良事件的危险因素(P<0.05)。相关分析显示维持性血液透析患者RDW与CRP呈现正相关关系(γ=0.336,P<0.05)。ROC曲线显示:RDW预测心血管不良事件的AUC值为0.762,截断值为18.6%,截断值预测心血管不良事件的敏感度为0.794,特异度为0.717,约登指数为0.501,CRP预测心血管不良事件的AUC值为0.794,截断值为12.4 mg/L,截断值预测心血管不良事件的敏感度为0.762,特异度为0.732,约登指数为0.494。结论 RDW与维持性血液透析患者微炎症状态及心血管不良事件的发生有关,检测RDW与CRP有助于预测近期心血管不良事件的发生风险。Objective To investigate the coreclation of distribution width of red blood cells(RDW)with micro inflammatory state and cardiovascular adverse events in patients with maintenance blood frontocephaly. Methods From Jan 2019 to Apr 2021,424 patients with maintenance hemodialysis were selected and followed up for this Hospital at Queshancounty. According to whether the patients had cardiovascular adverse events,they were divided into two groups:adverse event group(n=71)and control group(n=353).levels of red blood cell parameters and CRP were compared between adverse event groupand and control group. The risk factors of cardiovascular adverse events in maintenance hemodialysis patients were analyzed by logistic regression analysis,relationship between RDW and CRP was analyzed with correlation analysis,and ROC curve were drawn to analyze the predictive value of RDW and CRP for cardiovascular adverse events inmaintenance hemodialysis patients. Results Level of RBC,Hb,Hct,MHC were lower in adverse event group than in control group,difference was statistically significant(P<0.05),MCV,RDW and CRP were higher in adverse event group than in control group,difference was statistically significant(P<0.05). Logistic correlation analysis showed that RDW and CRP were independent risk factors for vascular adverse events in maintenance hemodialysis patients(P<0.05). Correlation analysis showed there was a positive correlation between RDW and CRP in maintenance hemodialysis patients(γ=0.336,P<0.05). ROC curve shows that AUC value of RDW for predicting cardiovascular adverse events is 0.762,cutoff value is 18.6%,sensitivity of the cutoff predicting cardiovascular adverse events is 0.794,the specificity is 0.717,Jordan index is 0.501,and CRP predicts cardiovascular,AUC of adverse events was 0.794,cut off was 12.4 mg/L,and sensitivity was0.762,specificity was 0.732,and Jordan index was 0.494. Conclusion RDW is related to micro inflammatory symptoms and cardiovascular adverse events in maintenance hemodialysis patients.detectiig of RDW

关 键 词：维持性血液透析 RDW CRP 微炎症 心血管不良事件 

分 类 号：R692.5[医药卫生—泌尿科学]