红细胞分布宽度变异系数与维持性血液透析患者远期预后的相关性分析  

Correlation analysis of variation coefficient of red blood cell distribution width and long-term prognosis of patients undergoing maintenance hemodialysis

作　　者：方倩 吴莉莉[1] 孙东颖[1] 李慧妍[1] QianFang;Lili WU;Dongying SUN;Huiyan LI(First Hospital of Qinhuangdao hemodialysis room,HeBei QinHuangDao,066000,China)

机构地区：[1]秦皇岛市第一医院血液透析室,秦皇岛066000

出　　处：《湖南师范大学学报（医学版）》2022年第6期79-83,共5页Journal of Hunan Normal University(Medical Sciences)

基　　金：秦皇岛市科学技术研究与发展计划(项目编号:202004A110)。

摘　　要：目的:研究确认红细胞分布宽度变异系数与维持性血液透析患者远期预后的相关性.方法:选择2014年1月~2021年1月到我院血液透析室进行维持性透析患者.所有入组患者均采用标准碳酸氢盐和双重反渗水进行透析治疗.对患者合并症、原发病、性别以及年龄等一般资料进行记录,以患者开始透析时间进行随访,患者存活时间为开始透析至死亡时间,随访截止日期为2022年4月30日.对患者红细胞分布宽度、血常规、肾功能、总胆固醇、甘油三酯等指标进行检测.依据患者红细胞分布宽度水平的中位数进行分组,其中RDW<14.50%为A组,RDW≥14.50%为B组.结果:全因死亡患者122名,其中A组患者死亡69名,B组患者死亡53例,Log-rank检验显示A组和B组患者生存率差异存在统计学意义,A组患者的生存率明显高于B组.依据患者生存情况将患者分为存活组和死亡组,单因素Cox回归分析结果显示患者红细胞分布宽度、血磷、血钙、尿素、原发病、合并高血压、脑卒中、冠心病、心衰以及开始透析年龄等因素是影响患者预后的影响因素,多因素COX回归分析结果显示,患者红细胞分布宽度、合并糖尿病、脑卒中、冠心病、EF值和开始透析年龄是患者预后不良的独立预测因素.结论:红细胞分布宽度变异系数与维持性血液透析患者远期预后存在相关性,红细胞分布宽度变异系数越大患者预后越差.Objective To study the correlation between the coefficient of variation of red blood cell distribution width and long-term prognosis of patients undergoing maintenance hemodialysis.Methods From January 2014 to January 2021,212 patients who underwent maintenance dialysis in the hemodialysis Center of nephrology department of our hospital were selected.All patients were treated with standard bicarbonate and double reverse osmosis.General information such as comorbidities,primary disease,gender and age of the patients were recorded.Patients were followed up based on the start time of dialysis,and the survival time of the patients was from the start time of dialysis to the time of death.The follow-up deadline was April 30,2022.Red blood cell distribution width,blood routine,renal function,total cholesterol,triglyceride and other indicators were detected.Patients were grouped according to the median level of red blood cell distribution width,in which RDW<14.50% was group A,RDW≥14.50% was group B.Results Among 122 patients with all-cause death,69 patients died in group A,While 53 patients died in group B.The survival rate of group A was significantly higher than that of group B via Log-rank test.According to the survival of patients were divided into survival group and death group,the results showed that red blood cell distribution width,blood phosphorus,blood calcium,urea,primary disease,hypertension,stroke,coronary heart disease,heart failure and the age at the beginning of dialysis were the influencing factors for the prognosis of patients,while uric acid and gender were less influential factors for the prognosis of patients.Multivariate COX regression analysis,showed that red blood cell distribution width,complicated with diabetes,stroke,coronary heart disease,EF value and age at the beginning of dialysis were independent predictors of poor prognosis.Conclusion The coefficient of variation of red blood cell distribution width is correlated with the long-term prognosis of patients on maintenance hemodialysis,and t

关 键 词：红细胞分布宽度 维持性血液透析 远期预后 慢性肾脏病 

分 类 号：R459.5[医药卫生—治疗学]