慢性肾脏病患者红细胞分布宽度与左心室舒张功能不全的关系

目的:探讨慢性肾脏病（CKD）患者红细胞分布宽度（RDW）与左心室舒张功能不全（LVDD）的关系，评估RDW对于CKD患者LVDD的预测价值。方法:选取2015年1月至2020年2月在广东药科大学附属第一医院住院并行超声心动图的成年CKD患者，男83例、女49例。记录患者的一般资料、病史、血常规及生化指标、心脏超声指标...

Relationship between red blood cell distribution width and left ventricular diastolic dysfunction in patients with chronic kidney diseases

Objective　To investigate the relationship between red blood cell distribution width(RDW) and left ventricular diastolic dysfunction (LVDD) in patients withchronic kidney diseases (CKD), and to evaluate the predictive value of RDW forLVDD in CKD patients. Methods　Adult CKD patientswho were hospitalized and underwent echocardiography in The First AffiliatedHospital of Guangdong Pharmaceutical University from January 2015 to February2020 were selected, including 83 males and 49 females. The general data,medical history, blood routine, biochemical indexes, and echocardiographic indexeswere recorded. The general data and clinical indicators were compared betweenthe normal left ventricular diastolic function group and the LVDD group.Independent sample t test was usedfor inter-group comparison of the measurement data with normal distribution,non-parametric rank sum test was used for inter-group comparison of themeasurement data with abnormal distribution, Chi-square test was used forinter-group comparison of the count data, Spearman rank correlation was usedfor correlation analysis, and binary logistic regression analysis was used forrisk factor analysis of LVDD. Receiver operating characteristic curve (ROC) andarea under curve (AUC) were used to evaluate the predictive value of RDW forLVDD. Results　There were 59 casesin the normal left ventricular diastolic function group and 73 cases in theLVDD group. The systolic blood pressure and RDW of the LVDD group were higherthan those of the other group (both P<0.05);the proportion of coronary heart disease in the LVDD group was higher than thatin the other group (P=0.037); leftventricular mass index (LVMI) and early diastolic transmitral velocity to earlymitral anulus diastolic velocity ratio (E/e') of the LVDD group weresignificantly higher than those of the other group, and e' was lower than thatof the other group (all P<0.05).Univariate correlation analysis showed that RDW was positively correlated withE/e', interventricular septal thickness (IVST), phosphorus (P),calcium-phosphorus product (Ca×P), cystatin C (CysC), and brain natriureticpeptide (BNP) (all P<0.05), andnegatively correlated with estimated glomerular filtration rate (eGFR) andhemoglobin (Hb) (both P<0.05).E/e' was positively correlated with left ventricular end-diastolic dimension(LVDd), LVMI, end-systolic volume (ESV), end-diastolic volume (EDV), ratio ofearly to late diastolic peak velocity of mitral flow (E/A), P, Ca×P, CysC, andRDW (all P<0.05), and negativelycorrelated with e', eGFR, Hb, total cholesterol (TC), and low densitylipoprotein (LDL) (all P<0.05).Multivariate logistic regression analysis showed that RDW was a risk factor ofLVDD (OR>1), and Hb was aprotective factor of LVDD (OR<1).ROC analysis showed that the AUC of LVDD predicted by RDW was 0.612, thesensitivity was 78.9%, and the specificity was 50.8%. Conclusions　LVDD is more likely to occur in CKD patients. Detection of RDW is ofcertain value in predicting LVDD in CKD patients.