CAJ | 학술논문

目的：探讨维持性血液透析患者红细胞分布宽度（RDW）与心血管死亡风险的关系。方法选择接受规律血液透析治疗的患者，根据 RDW 正常值范围的界值（15．5％）分成2组，主要终点事件是死亡。2组间累计的全因死亡风险采用 Kaplan-Meier 曲线和 Cox 回归分析。结果共613例维持性血液透析患者纳入本研究，随访时间为32．8（3．0，95．1）个月，RDW 为14．3％（9．2％，26．1％）。与 RDW ＜15．5％组的441例患者相比，RDW≥15．5％组的172例患者1、3、5年的累积心血管生存率明显下降，分别为88％、77％、70％，且心血管死亡发生率明显高于 RDW ＜15．5％组患者（P ＜0．001）。多因素 Cox 回归校正多项混杂因素后，发现 RDW≥15．5％是血液透析患者发生心血管死亡的独立危险因素（HR ＝1．63，95％ CI：1．09～2．49，P ＝0．011）。结论高 RDW 可增加维持性血液透析患者的心血管病死率，增加死亡风险。
목적：탐토유지성혈액투석환자홍세포분포관도（RDW）여심혈관사망풍험적관계。방법선택접수규률혈액투석치료적환자，근거 RDW 정상치범위적계치（15．5％）분성2조，주요종점사건시사망。2조간루계적전인사망풍험채용 Kaplan-Meier 곡선화 Cox 회귀분석。결과공613례유지성혈액투석환자납입본연구，수방시간위32．8（3．0，95．1）개월，RDW 위14．3％（9．2％，26．1％）。여 RDW ＜15．5％조적441례환자상비，RDW≥15．5％조적172례환자1、3、5년적루적심혈관생존솔명현하강，분별위88％、77％、70％，차심혈관사망발생솔명현고우 RDW ＜15．5％조환자（P ＜0．001）。다인소 Cox 회귀교정다항혼잡인소후，발현 RDW≥15．5％시혈액투석환자발생심혈관사망적독립위험인소（HR ＝1．63，95％ CI：1．09～2．49，P ＝0．011）。결론고 RDW 가증가유지성혈액투석환자적심혈관병사솔，증가사망풍험。
Objective To explore the relationship between red blood cell distribution width (RDW) and cardiovascular-related mortality risk in maintenance hemodialysis patients.Methods In this study,613 patients who underwent regular hemodialysis were recruited and categorized into two groups according to the cut-off value of RDW (15.5%)of normal range.The main end-point event was death.All-cause mortality risk be-tween two groups was evaluated using Kaplan-Meier curve and Cox regression analysis.Results A total of 613 enrolled patients had a median follow-up of 32.8 months (range:3.0 ~95.1 months).The median value of RDW was 14.3% (range:9.2%~26.1%).Compared with 441 patients with RDW <15.5%,the accumula-ted 1-,3-and 5-year cardiovascular survival rates were significantly decreased to 88%,77% and 70% in 172 patients with RDW≥15.5% and the cardiovascular related mortality was significantly higher (P <0.001 ). After the adjustment of multiple confounding factors by Cox regression analysis,RDW≥15.5% was a inde-pendent risk factor of cardiovascular-related mortality in hemodialysis patients (HR =1.63,95% CI:1.09 ~2.49,P =0.011).Conclusion High level of RDW enhanced the cardiovascular-related mortality and the risk of death.