维持性血液透析患者发生左心室肥厚的影响因素及RDW、hs-CRP的预测价值(1)
[摘要] 目的 探讨维持性血液透析(MHD)患者发生左心室肥厚(LVH)的影响因素及红细胞分布宽度(RDW)、血清超敏C-反应蛋白(hs-CRP)的预测价值。 方法 收集2016年6月～2019年6月安徽省第二人民医院收治的MHD≥3个月的终末期肾脏病患者，共135例。根据左心室质量指数(LVMI)将患者分为LVH组(69例)和非LVH组(66例)，收集患者人口学资料、实验室指标以及影像学检查。采用logistic回归分析MHD患者发生LVH的影响因素，绘制受试者工作特征(ROC)曲线评估RDW和hs-CRP对LVH的预测价值。 结果 LVH组年龄、收缩压、RDW、尿酸、总胆固醇、三酰甘油、左心室舒张末内径、hs-CRP高于非LVH组，高血压史、糖尿病史比例多于非LVH组，差异有统计学意义(P < 0.05)。年龄、收缩压、有高血压史、有糖尿病史、RDW、hs-CRP是MHD患者LVH的独立危险因素(P < 0.05)。RDW、hs-CRP的曲线下面积分别为0.900(0.871～0.929)、0.837(0.799～0.876)，联合检测的预测价值更高[0.934(0.913～0.954)]。 结论 年龄、收缩压、有高血压史、有糖尿病史、RDW、hs-CRP是MHD患者LVH独立危险因素，早期RDW、hs-CRP联合检测对MHD患者LVH具有预测价值。
[关键词] 维持性血液透析;红细胞分布宽度;超敏C-反应蛋白;左心室肥厚
[中图分类号] R459.5 [文獻标识码] A [文章编号] 1673-7210(2020)04(c)-0185-04
Influencing factors of left ventricular hypertrophy and the predictive value of RDW and hs-CRP in maintenance hemodialysis patients
LU Jin ZHANG Hongxu ZHANG Yuqin LIU Yiran ZHANG Chaoqun
Department of Nephrology， Anhui No.2 Provincial People′s Hospital， Anhui Province， Hefei 230011， China
[Abstract] Objective To explore the influencing factors of left ventricular hypertrophy (LVH) and the predictive value of red blood cell distribution width (RDW) and serum hypersensitive C-reactive protein (hs-CRP) in maintenance hemodialysis (MHD) patients. Methods A total of 135 patients with end-stage renal disease who were admitted to Anhui No.2 Provincial People′s Hospital for MHD≥3 months from June 2016 to June 2019 were collected. According to the left ventricular mass index (LVMI)， they were divided into LVH group (69 cases) and non-LVH group (66 cases)， while patient demographic data， laboratory indicators， and imaging studies were collected. Demographic data， laboratory indicators and imaging examination of each group were collected. Logistic regression was used to analyze the influencing factors of LVH in MHD patients， and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of RDW and hs-CRP to LVH. Results The age， systolic blood pressure， RDW， uric acid， total cholesterol， triacylglycerol， left ventricular end-diastolic diameter and hs-CRP in the LVH group were higher than those in the non-LVH group， and the differences were statistically significant (P < 0.05). Age， systolic blood pressure， history of hypertension， history of diabetes， RDW， hs-CRP were independent risk factors for LVH in MHD patients (P < 0.05). The areas under the curve of RDW and hs-CRP were 0.900 (0.871-0.929) and 0.837 (0.799-0.876)， respectively， while the predictive value of joint detection was higher [0.934 (0.913-0.954)]. Conclusion Age， systolic blood pressure， history of hypertension， history of diabetes， RDW and hs-CRP are independent risk factors of LVH in MHD patients. Early combined detection of RDW and hs-CRP has predictive value for LVH in MHD patients., 百拇医药(卢进 张洪旭 张育琴 刘怡然 章超群)
[关键词] 维持性血液透析;红细胞分布宽度;超敏C-反应蛋白;左心室肥厚
[中图分类号] R459.5 [文獻标识码] A [文章编号] 1673-7210(2020)04(c)-0185-04
Influencing factors of left ventricular hypertrophy and the predictive value of RDW and hs-CRP in maintenance hemodialysis patients
LU Jin ZHANG Hongxu ZHANG Yuqin LIU Yiran ZHANG Chaoqun
Department of Nephrology， Anhui No.2 Provincial People′s Hospital， Anhui Province， Hefei 230011， China
[Abstract] Objective To explore the influencing factors of left ventricular hypertrophy (LVH) and the predictive value of red blood cell distribution width (RDW) and serum hypersensitive C-reactive protein (hs-CRP) in maintenance hemodialysis (MHD) patients. Methods A total of 135 patients with end-stage renal disease who were admitted to Anhui No.2 Provincial People′s Hospital for MHD≥3 months from June 2016 to June 2019 were collected. According to the left ventricular mass index (LVMI)， they were divided into LVH group (69 cases) and non-LVH group (66 cases)， while patient demographic data， laboratory indicators， and imaging studies were collected. Demographic data， laboratory indicators and imaging examination of each group were collected. Logistic regression was used to analyze the influencing factors of LVH in MHD patients， and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of RDW and hs-CRP to LVH. Results The age， systolic blood pressure， RDW， uric acid， total cholesterol， triacylglycerol， left ventricular end-diastolic diameter and hs-CRP in the LVH group were higher than those in the non-LVH group， and the differences were statistically significant (P < 0.05). Age， systolic blood pressure， history of hypertension， history of diabetes， RDW， hs-CRP were independent risk factors for LVH in MHD patients (P < 0.05). The areas under the curve of RDW and hs-CRP were 0.900 (0.871-0.929) and 0.837 (0.799-0.876)， respectively， while the predictive value of joint detection was higher [0.934 (0.913-0.954)]. Conclusion Age， systolic blood pressure， history of hypertension， history of diabetes， RDW and hs-CRP are independent risk factors of LVH in MHD patients. Early combined detection of RDW and hs-CRP has predictive value for LVH in MHD patients., 百拇医药(卢进 张洪旭 张育琴 刘怡然 章超群)