红细胞体积分布宽度预测腹膜透析相关腹膜炎患者预后的价值

目的探讨红细胞体积分布宽度(RDW)对腹膜透析相关性腹膜炎患者预后的评估意义。方法前瞻性收集2012年10月至2014年10月在南海医院接受腹膜透析(CAPD)治疗的患者,将发生腹膜透析相关性腹膜炎患者作为研究对象,并对上述患者随访18个月,同时记录研究对象临床资料与实验室检查数据。结果共有研究对象59例,平均透析时间(14.98±3.6)个月,再发腹膜炎(1.4±0.5)次。其中,存活组54例,死亡组5例,透析时间、心血管事件、红细胞分布宽度变异系数(RDW-CV)水平在死亡组发生率更高。进一步根据COX回归分析得出,腹膜炎患者心血管事件(HR=0.765,95%CI:0.107~0.388,P=0.072)、RDW-CV水平(HR=0.681,95%CI:0.518~0.985,P=0.058)并不是影响患者死亡的危险因素,而透析时间长短(HR=1.03,95%CI:0.788~1.857,P=0.023)与腹膜炎患者预后相关。结论腹膜透析患者存在微炎症状态,RDW-CV可能参与炎症变化过程,但并不是影响患者预后的独立危险因素,仍需更多的研究。

Value of red blood cell volume distribution width for predicting prognosis in patients with peritoneal dialysis-associated peritonitis

Objective To explore the evaluation significance of the red blood cell volume distribution width(RDW) for the prog‐nosis in the patients with peritoneal dialysis‐associated peritonitis .Methods The patients receiving the continuous ambulatory peri‐toneal dialysis(CAPD) and developing peritoneal dialysis‐associated peritonitis were prospectively collected in our hospital from Oc‐tober 2012 to October 2014 and served as the research subjects for conducting 18‐month followed up ,as well as their clinical data and laboratory detection data .Results There were 59 research subjects were enrolled ,the average dialysis time was (14 .98 ± 3 .6) months and the number of re‐peritonitis was (1 .4 ± 0 .5) times .Among them ,54 cases were survival and 5 cases died ,the dialysis time ,cardiovascular events ,RDW‐CV levels in the death group were higher .Cox regression analysis obtained that the cardiovascular events (HR=0 .765 ,95% CI:0 .107-0 .388 ,P=0 .072) and RDW level (HR=0 .681 ,95% CI:0 .518-0 .985 ,P=0 .058) were not the risk factors affecting patients′death ,while the dialysis time(HR=1 .03 ,95% CI:0 .788 -1 .857 ,P=0 .023) was related with the prognosis in the peritonitis patients .Conclusion The microinflammation status exists in the CAPD patients ,RDW may be in‐volved in the inflammatory process ,but it is not an independent risk factor affecting the prognosis of the patients with peritoneal di‐alysis‐associated peritonitis ,which needs more studies .