Abstract:【Objective】To analyze the predictive value of red blood cell distribution width (RDW) combined with high-sensitivity troponin T (hs-cTnT) in maintenance hemodialysis (MHD) patients with left ventricular diastolic dysfunction. 【Methods】A total of 80 MHD patients in our hospital from April 2019 to February 2021 were selected. The serum hs-cTnT level and RDW level of the patients before dialysis were collected. In addition,Doppler ultrasound was used to detect the early diastolic wave (E') and early diastolic peak flow rate (E) of the mitral valve. According to the test results,patients were divided into the diastolic dysfunction group and normal diastolic function group according to the test results. Logistic multivariate regression analysis was used to investigate the related factors affecting left ventricular diastolic dysfunction in patients; And receiver operating characteristic curve (ROC) was used to determine the effects of RDW and hs-cTnT levels on predictive value for patients to have complication with left ventricular diastolic disfunction. 【Results】Among the 80 MDH patients,49 cases (61.25%) had left ventricular diastolic dysfunction,and 31 patients (38.75%) had normal left ventricular diastolic function. The diastolic dysfunction group has a higher proportion of diabetes history,RDW,water load,and hs-cTnT level compared to the normal diastolic group. The ultrafiltration volume/BMI level of the diastolic dysfunction group was lower than that of the normal diastolic group (P<0.05). Logistic multivariate regression analysis showed that a history of diabetes,RDW,high water load,hs-cTnT expression level and low ultrafiltration volume/BMI expression level were the risk factors for left ventricular diastolic dysfunction in MDH patients (P<0.05). ROC analysis showed that the area under the curve (AUC) of RDW and hs-cTnT single and combined predictions for patients with left ventricular diastolic dysfunction were 0.804,0.807,and 0.888,respectively. The predictive power of RDW and hs-cTnT alone on patients with left ventricular diastolic dysfunction was lower than that of the combination of the two measurements (P<0.05). 【Conclusion】MHD patients with high expression levels of RDW and hs-cTnT are more likely to have left ventricular diastolic dysfunction. Thus,RDW and hs-cTnT have certain clinical predictive value for MHD patients with left ventricular diastolic dysfunction.
史晓艳, 申迎春. 红细胞分布宽度联合超敏肌钙蛋白T对MHD患者左室舒张功能障碍的预测价值[J]. 医学临床研究, 2022, 39(12): 1830-1833.
SHI Xiao-yan, SHEN Ying-chun. Predictive Value of RDW Combined with hs-cTnT on Left Ventricular Diastolic Dysfunction in MHD Patients. JOURNAL OF CLINICAL RESEARCH, 2022, 39(12): 1830-1833.
[1] JAMEEL F A,JUNEJO A M,KHAN Q,et al. Echocardiographic changes in chronic kidney disease patients on maintenance hemodialysis[J].Cureus,2020,12(7):e8969.
[2] ZANIB A,ANWAR S,SALEEM K,et al. Frequency of left ventricular hypertrophy among patients on maintenance hemodialysis by voltage criteria and its relationship with biophysical-chemical parameters[J].Cureus,2020,12(3):e7426.
[3] 卢进,张洪旭,张育琴,等. 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[J].中国医药导报,2020,17(12):185-188.
[4] 孙宁玲,王继光. 亚洲高血压合并左心室肥厚诊治专家共识[J].中华高血压杂志,2016,24(7):619-627.
[5] JOSEPH M S,PALARDY M,BHAVE N M. Management of heart failure in patients with end-stage kidney disease on maintenance dialysis:a practical guide[J].Rev Card Med,2020,21(1):31-39.
[6] RUGGENENTI P,PODESTA M A,TRILLINI M,et al. Ramipril and cardiovascular outcomes in patients on maintenance hemodialysis:the ARCADIA multicenter randomized controlled trial[J].Clin J Am Soc Nephrol,2021,16(4):575-587.
[7] 陈富华,王琴,王筱霞,等. 血红蛋白联合红细胞分布宽度预测维持性血液透析患者心血管事件的临床研究[J].中国中西医结合肾病杂志,2020,21(9):789-791.
[8] 甘言刚,赵明明,滕洁,等. 维持性血液透析患者左心室舒张功能障碍的危险因素及预测模型[J].肾脏病与透析肾移植杂志,2021,30(1):31-36.
[9] 吴敏,侯毅,李广义,等. 影响维持性血液透析患者左心室舒张功能不全的多因素分析[J].中国血液净化,2020,19(5):298-300.