【摘要】 目的了解维持性血液透析患者红细胞分布宽度（red blood cell distribution width,RDW）与促红细胞生成素抵抗的相关性。方法在2015年3月至2016年3月新桥医院血液透析中心行维持性透析及重组人促红细胞生成素治疗≥6个月660例患者中筛选出资料完整的253例(根据每周rhu EPO治疗剂量分为3亚组:A组,rhu EPO治疗剂量<150 IU·kg^-1·week^-1,共有82例患者;B组,150 IU·kg^-1·week^-1≤rhu EPO治疗剂量<300 IU·kg^-1·week^-1,共有137例患者;C组,rhuEPO治疗剂量≥300 IU·kg^-1·week^-1,共34例患者)进行回顾性分析,考察RDW与促红细胞生成素抵抗指数（erythropoietin resistance index,ERI）的相关性;同时选取健康成人200例,比较2组RDW的差异。结果秩和检验提示血透组RDW显著高于健康对照组（P<0.05）,不同rhu EPO治疗剂量组血液透析患者中RDW、ERI有显著差异。Person分析结果显示:ERI与血红蛋白（r=-0.434,P<0.000 1）、血清铁（r=-0.168,P=0.008）呈负相关;与RDW（r=0.294,P<0.000 1）、透析月龄（r=0.180,P=0.004）、ln CRP（r=0.200,P=0.001）呈正相关。多元线性回归显示:血红蛋白、RDW与ERI显著相关。结论在血透患者中,RDW与ERI独立相关,对于促红细胞生成素抵抗的判断、指导rhu EPO的临床应用,具有重要参考价值。更多还原

【Abstract】 This study was performed to investigate the correlation between red cell distribution width（RDW）and erythropoietin resistance in maintenance hemodialysis patients. From march 2015 to march 2016, we collected660 patients who underwent hemodialysis and recombinant human erythropoietin as treatment for more than sixmonths in hemodialysis center of Xinqiao Hospital, then 253 patients with completed data were selected and dividedinto three subgroups according to the weekly doses of rhu EPO: group A(rhu EPO dose <150 IU·kg^-1·week^-1, n=82),group B(150 IU·kg^-1·week^-1≤ rhu EPO dose <300 IU·kg^-1·week^-1, n=137), and group C(rhu EPO dose ≥300 IU·kg^-1·week^-1, n=34) for retrospective analysis and exploring the correlationship between RDW and erythropoietinresistance index（ERI）. Meanwhile 200 healthy adults were recruited as control group, and the difference of RDWbetween patients and control was analyzed. Rank sum test indicated that the RDW of dialysis group was significantlyhigher than that of the healthy control group（P<0.05）. Data also showed that there were significant differences inRDW and ERI among groups A, B and C of hemodialysis patients. Person analysis showed that ERI was negativelycorrelated with hemoglobin（r=-0.434, P<0.000 1）, serum iron（r=-0.168, P=0.008）, while positively correlated withRDW（r=0.294, P<0.000 1）, dialysis age（r=0.180, P=0.004）, ln CRP（r=0.200, P=0.001）. Multiple linear regressionshowed that hemoglobin, RDW and ERI were significantly correlated. Our result indicated that RDW is positively correlated with the resistance index, which has an important reference value for judgment of erythropoietinresistance and the clinical application of erythropoietin in hemodialysis patients.更多还原