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目的在心血管疾病(cardiovascular disease,CVD)患者中,红细胞分布宽度(red blood cell distribution width,RDW)与心血管死亡及全因死亡相关。但在血液透析患者中,RDW与CVD及预后的相关性尚无报道。因此,本研究旨在探讨RDW对血液透析患者心血管事件发生及死亡的影响。方法纳入广东省人民医院血液透析患者共286名,随访时间为2009年1月1日~2014年12月31日。记录一般资料、实验室检查等,终点是心血管事件、心血管死亡及全因死亡。结果平均随访时间57.2月,286名血液透析患者中96人(33.5%)死亡,57人(19.9%)发生心血管死亡,119人(42%)发生心血管事件。多因素生存分析,经校正后,RDW仍是全因死亡、心血管死亡及心血管事件的独立危险因素,危险比值分别为1.36(95%CI 1.17~1.58,P<0.001)、1.38(95%CI 1.16~1.64,P<0.001)和1.22(95%CI1.06~1.40,P=0.006)。结论 RDW升高是血液透析患者全因死亡及心血管死亡和心血管事件的独立危险因素。
Objectives In patients with cardiovascular disease (CVD), the red blood cell distribution width (RDW) is associated with cardiovascular death and all-cause mortality. However, in hemodialysis patients, the relationship between RDW and CVD and prognosis has not been reported yet. Therefore, the aim of this study was to investigate the effect of RDW on cardiovascular events and mortality in hemodialysis patients. Methods A total of 286 hemodialysis patients were enrolled in Guangdong Provincial People’s Hospital. The follow-up time ranged from January 1, 2009 to December 31, 2014. Record general information, laboratory tests, etc., the end point is a cardiovascular event, cardiovascular death and all-cause death. Results The mean follow-up time was 57.2 months. 96 (33.5%) of 286 hemodialysis patients died, 57 (19.9%) had cardiovascular deaths and 119 (42%) had cardiovascular events. In multivariate survival analysis, RDW was still an independent risk factor for all-cause mortality, cardiovascular death and cardiovascular events after adjustment. The hazard ratios were 1.36 (95% CI 1.17-1.58, P <0.001), 1.38 (95% CI 1.16-1.64, P <0.001) and 1.22 (95% CI 1.06-1.40, P = 0.006). Conclusions Elevated RDW is an independent risk factor for all-cause and cardiovascular deaths and cardiovascular events in hemodialysis patients.