中国血液净化

中国血液净化 ›› 2018, Vol. 17 ›› Issue (11): 739-742.doi: 10.3969/j.issn.1671-4091.2018.11.005

• 临床研究 • 上一篇    下一篇

红细胞分布宽度与血液透析低血压相关性探索

朱润章1,高占辉1,王笑云1.2,余燕婷1,季大玺1   

  1. 1. 南京医科大学附属明基医院肾脏内科

    2. 江苏省人民医院肾内科
  • 收稿日期:2018-06-15 修回日期:2018-08-31 出版日期:2018-11-12 发布日期:2018-11-13
  • 通讯作者: 季大玺 dr_jdx@163.com E-mail:dr_jdx@163.com

Correlation between red blood cell distribution width and intradialytic hypotension

  • Received:2018-06-15 Revised:2018-08-31 Online:2018-11-12 Published:2018-11-13

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摘要： 【摘要】目的研究红细胞分布宽度(red blood cell distribution width，RDW)与透析相关性低血压(intradialytic hypotension，IDH)之间的关系。方法选取2017 年1 月1 日～2018 年6 月1 日南京医科大学附属明基医院血液透析中心行维持性血液透析患者238 例作为研究对象，根据透析期间是否发生IDH 分为观察组(50 例)和对照组(188 例)。记录2 组患者低血压发生事件和RDW，采用独立样本t 检验探讨IDH 和RDW、血红蛋白、年龄、性别、总胆固醇、低密度脂蛋白(low density lipoprotein，LDL)、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IDH 的独立影响因素。绘制受试者工作特征曲线(receiver operating characteristic curve，ROC 曲线)，评价RDW 对IDH 的诊断价值。P＜0.05 为差异有统计学意义。结果观察组和对照组在性别(t=10.024，P=0.002)、年龄(t=4.875，P＜0.001)、RDW(t=5.673，P＜0.000)、总胆固醇(t=3.065，P=0.002)、LDL(t=2.787，P=0.006)方面，2 组存在统计学差异。纠正IDH 后，RDW 下降，较纠正前有统计学意义(t=5.805，P＜0.001)。ROC 曲线显示，曲线下面积AUC=0.869，95%置信区间为0.791～0.926，OR=1.249，具有较好的预测价值。结论RDW 升高是IDH 的重要危险因素，具有较好的预测价值。

关键词: 红细胞分布宽度, 低血压, 血液透析

Abstract: 【Abstract】Objective To explore the relationship between red blood cell distribution width (RDW) and intradialytic hypotension (IDH). Methods A total of 238 cases of maintenance hemodialysis patients treated in the hemodialysis center of our hospital during January 1st, 2017～June 1st, 2018 were recruited as research subjects. According to the presence or absence of IDH, they were divided into observation group (50 cases) and control group (188 cases). IDH and RDW were recorded in the two groups. Independent sample t test was used to investigate the relationship between IDH and RDW, hemoglobin, age, gender, total cholesterol, low density lipoprotein (LDL), phosphorus, calcium, parathyroid hormone, etc. Multivariate logistic regression was used to analyze the independent influence factors for IDH. The receiver operating characteristic curve (ROC curve) was obtained to evaluate the diagnostic value of RDW for IDH. P<0.05 was considered to be statistically significant. Results There were significant differences in gender (t=10.024, P=0.002), age (t=4.875, P=0.000), RDW (t=5.673, P=0.000), total cholesterol (t=3.065, P=0.002) and LDL (t=2.787, P=0.006) between the two groups. After correction of IDH, RDW became lower but still had statistically significance (t=5.805, P＜0.001). The ROC curve showed that RDW had a predictive effect for IDH (AUC=0.869, 95% CI 0.791～0.926, OR=1.249). Conclusions The increase of RDW is an important risk factor as well as a better predictive index for IDH.

Key words: Red blood cell distribution width, hypotension, hemodialysis