论文部分内容阅读
目的了解维持性血液透析患者红细胞分布宽度(red blood cell distribution width,RDW)与促红细胞生成素抵抗的相关性。方法在2015年3月至2016年3月新桥医院血液透析中心行维持性透析及重组人促红细胞生成素治疗≥6个月660例患者中筛选出资料完整的253例(根据每周rhu EPO治疗剂量分为3亚组:A组,rhu EPO治疗剂量<150 IU·kg~(-1)·week~(-1),共有82例患者;B组,150 IU·kg~(-1)·week~(-1)≤rhu EPO治疗剂量<300 IU·kg~(-1)·week~(-1),共有137例患者;C组,rhuEPO治疗剂量≥300 IU·kg~(-1)·week~(-1),共34例患者)进行回顾性分析,考察RDW与促红细胞生成素抵抗指数(erythropoietin resistance index,ERI)的相关性;同时选取健康成人200例,比较2组RDW的差异。结果秩和检验提示血透组RDW显著高于健康对照组(P<0.05),不同rhu EPO治疗剂量组血液透析患者中RDW、ERI有显著差异。Person分析结果显示:ERI与血红蛋白(r=-0.434,P<0.000 1)、血清铁(r=-0.168,P=0.008)呈负相关;与RDW(r=0.294,P<0.000 1)、透析月龄(r=0.180,P=0.004)、ln CRP(r=0.200,P=0.001)呈正相关。多元线性回归显示:血红蛋白、RDW与ERI显著相关。结论在血透患者中,RDW与ERI独立相关,对于促红细胞生成素抵抗的判断、指导rhu EPO的临床应用,具有重要参考价值。
Objective To investigate the correlation between red blood cell distribution width (RDW) and erythropoietin resistance in maintenance hemodialysis patients. Methods From March 2015 to March 2016, 253 patients with complete data were selected from 660 patients with maintenance dialysis and recombinant human erythropoietin (≥6 months) at the Hemodialysis Center of Xinqiao Hospital (according to weekly rhu EPO The therapeutic doses were divided into 3 subgroups: Group A, rhu EPO at a dose of 150 IU · kg -1 (-1) · week -1, 82 patients in total; Group B, 150 IU · kg -1 · Week ~ (-1) ≤ rhu EPO treatment dose of 300 IU · kg -1 (-1) · week -1, a total of 137 patients; C group, rhuEPO treatment dose ≥ 300 IU · kg -1 ) · Week ~ (-1), a total of 34 patients) were retrospectively analyzed to investigate the correlation between RDW and erythropoietin resistance index (ERI). At the same time, 200 healthy adults were selected to compare RDW The difference. Results The rank sum test showed that RDW in hemodialysis group was significantly higher than that in healthy control group (P <0.05). RDW and ERI in hemodialysis patients with different doses of rhu EPO were significantly different. Person analysis showed that ERI was negatively correlated with hemoglobin (r = -0.434, P <0.000 1) and serum iron (r = -0.168, P = 0.008) Month age (r = 0.180, P = 0.004), ln CRP (r = 0.200, P = 0.001). Multiple linear regression showed that hemoglobin, RDW and ERI were significantly correlated. Conclusion In hemodialysis patients, RDW is independently associated with ERI, which has important reference value for judging erythropoietin resistance and guiding the clinical application of rhu EPO.