国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
International Journal of Urology and Nephrology
2015年
6期
896-899
,共4页
肾疾病%红细胞%心力衰竭
腎疾病%紅細胞%心力衰竭
신질병%홍세포%심력쇠갈
Kidney Diseases%Erythrocytes%Heart Failure
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.
目的 研究在慢性腎髒病(CKD)人群中紅細胞分佈寬度(RDW)和心力衰竭的關繫.方法 迴顧性巢式病例-對照設計,收集腎內科住院的非透析CKD患者的住院資料.結果 納入687例病例中97例(14.1％)住院閤併心力衰竭.與無心力衰竭組比較,心力衰竭組住院前3箇月的RDW水平更高(13.4±1.2和15.3±2.0,P=0.028),而住院期間RDW水平相似.住院前3箇月RDW與各項心髒血指標的相關性較住院期間RDW更好,與NT-proBNP、左室射血分數以及NYHA心功能分級相關,相關繫數為0.394、-0.357和0.294.在多變量Logistic迴歸模型中,住院前3箇月RDW每增加1％,髮生心力衰竭的風險增加49.2％(OR值95％可信區間1.094～1.703);在無貧血亞組中,住院前3箇月RDW每增加1％,心力衰竭風險增加57.0％(OR值95％可信區間1.132 ～2.031).住院前3箇月RDW預測心力衰竭的受試者工作特徵麯線下麵積為0.791(95％可信區間0.644～0.937,P=0.038).結論 對于非透析的住院CKD患者,住院前3箇月RDW和心力衰竭獨立相關,RDW升高可能是預測近期髮生心力衰竭的一箇有價值的標誌物.
목적 연구재만성신장병(CKD)인군중홍세포분포관도(RDW)화심력쇠갈적관계.방법 회고성소식병례-대조설계,수집신내과주원적비투석CKD환자적주원자료.결과 납입687례병례중97례(14.1％)주원합병심력쇠갈.여무심력쇠갈조비교,심력쇠갈조주원전3개월적RDW수평경고(13.4±1.2화15.3±2.0,P=0.028),이주원기간RDW수평상사.주원전3개월RDW여각항심장혈지표적상관성교주원기간RDW경호,여NT-proBNP、좌실사혈분수이급NYHA심공능분급상관,상관계수위0.394、-0.357화0.294.재다변량Logistic회귀모형중,주원전3개월RDW매증가1％,발생심력쇠갈적풍험증가49.2％(OR치95％가신구간1.094～1.703);재무빈혈아조중,주원전3개월RDW매증가1％,심력쇠갈풍험증가57.0％(OR치95％가신구간1.132 ～2.031).주원전3개월RDW예측심력쇠갈적수시자공작특정곡선하면적위0.791(95％가신구간0.644～0.937,P=0.038).결론 대우비투석적주원CKD환자,주원전3개월RDW화심력쇠갈독립상관,RDW승고가능시예측근기발생심력쇠갈적일개유개치적표지물.
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.
