摘要
目的 研究在慢性肾脏病（CKD）人群中红细胞分布宽度（RDW）和心力衰竭的关系.方法 回顾性巢式病例-对照设计,收集肾内科住院的非透析CKD患者的住院资料.结果 纳入687例病例中97例（14.1％）住院合并心力衰竭.与无心力衰竭组比较,心力衰竭组住院前3个月的RDW水平更高（13.4±1.2和15.3±2.0,P=0.028）,而住院期间RDW水平相似.住院前3个月RDW与各项心脏血指标的相关性较住院期间RDW更好,与NT-proBNP、左室射血分数以及NYHA心功能分级相关,相关系数为0.394、-0.357和0.294.在多变量Logistic回归模型中,住院前3个月RDW每增加1％,发生心力衰竭的风险增加49.2％（OR值95％可信区间1.094～1.703）;在无贫血亚组中,住院前3个月RDW每增加1％,心力衰竭风险增加57.0％（OR值95％可信区间1.132 ～2.031）.住院前3个月RDW预测心力衰竭的受试者工作特征曲线下面积为0.791（95％可信区间0.644～0.937,P=0.038）.结论 对于非透析的住院CKD患者,住院前3个月RDW和心力衰竭独立相关,RDW升高可能是预测近期发生心力衰竭的一个有价值的标志物。
Objectives To investigate the relationship between red blood cell distribution width（RDW） and heart failure in pre-dialysis patients with chronic kidney disease（CKD）.Methods Prospective nested case -control design.Data from hospitalized pre-dialysis patients with CKD were studied.Results Ninety-seven patients had heart failure in the included 687 patients.Compared with the patients without heart failure,those with heart failure had a higher RDW level 3 months before admission（13.4 ± 1.2 vs 15.3 ± 2.0,P =0.028）,however,a similar RDW level at admission.It seemed that the RDW level 3 months before admission had better values than RDW level at admission.It was associated with several renal and cardiovascular indices including eGFR,NT-proBNP,left ventricular ejection fraction and NYHA class with correlation coefficients of 0.394,-0.357 and 0.294.In multiple logistic aggression models,the risk of heart failure increased 49.2% for every 1% increase of RDW level 3 months before admission（95% confidence interval of odds ratio 1.094 ～ 1.703）.In the subgroup without anemia,the risk of heart failure increased 57.0% for every 1% increase of RDW level （95% confidence interval of odds ratio1.132 ～2.031）.The area under a receiver operating characteristic curve was 0.791 （95% confidence interval 0.644 ～ 0.937,P =0.038）.Conclusions RDW level 3 months before admission is independently associated with heart failure in pre-dialysis patients with CKD.The increased RDW is a promising prognostic marker for short-term heart failure.
出处
《国际泌尿系统杂志》
2015年第6期896-899,共4页
International Journal of Urology and Nephrology
关键词
肾疾病
红细胞
心力衰竭
Kidney Diseases
Erythrocytes
Heart Failure
