血液透析患者红细胞分布宽度及相关因素分析*

目的：分析血液透析患者红细胞分布宽度（RDW）及其影响因素。方法：165例维持性血液透析患者，男性103例，女性62例；平均年龄（52.2±12.9）岁；平均透析龄（5.8±3.3）年，以RDW正常值上限14.6%为界分为RDW正常组124例和RDW升高组41例，比较两组患者的一般资料和相关实验室检查指标，分析RDW与各指标的相关关系。结果：RDW正常组平均年龄、转铁蛋白低于RDW升高组，血清前白蛋白、肌酐、血钾、铁蛋白高于RDW升高组，差异均有统计学意义（P＜0.05）。Pearson相关分析显示，RDW与血清前白蛋白（r=-0.216，P=0.005）、透析前血肌酐（r=-0.156，P=0.046）、血清铁蛋白（r=-0.170，P=0.040）呈负相关（P＜0.05），与C反应蛋白（r=0.207，P=0.008）、转铁蛋白（r=0.216，P=0.005）呈正相关（P＜0.05）。结论：RDW与血液透析患者年龄、营养状况、炎症状态等因素有关，对RDW的监测有助于发现预后不良的高危人群，并可以通过干预其相关影响因素达到提高透析质量及改善透析患者预后的目的。

The evaluation of red cell distribution width and the related factors in hemodialysis patients

Objective: To investigate the status of red blood distribution width(RDW)and the related factors in hemodialysis(HD) patients. Methods:This study was carried out in 165 HD patients (103 male and 62 female) with the mean age of (52.2±12.9) years and mean dialysis vintage of (5.8±3.3) years. Clinical data of all patients were collected before dialysis including white blood cell count, hemoglobin(Hb), RDW, serum albumin, prealbumin, renal function, electrolyte, parathyroid hormone, C-reactive protein, ferritin and transferrin. Results: TThere are statistical difference of age, pre-albumin, serum creatinine, serum potassium, ferritin and transferring between the two groups(P<0.05). Pearson analysis showed RDW had a negative correlation with prealbumin(r=-0.216, P=0.005), serum creatinine (r=-0.156, P=0.046) and serum ferritin(r=-0.170, P=0.040). RDW had a possitive correlation with C-reactive protein(r=0.207, P=0.008) and transferrin(r=0.216, P=0.008). Conclusions: RDW has a relation with age, nutritional status and inflammation. Monitoring RDW is meaningful in finding out high risk groups with poor prognosis in hemodialysis patients. The intervention on RDW-related factors can improve the dialysis quality and the prognosis of dialysis patients.