中文摘要：

目的近年发现红细胞体积分布宽度（red blood cell distribution width，RDW）与慢性透析患者预后密切相关，本研究旨在探讨腹膜透析患者RDW的特点及其影响闳素。方法纳入我院103例行持续性非卧床腹膜透析治疗的尿毒症患者，根据患者开始腹膜透析时的年龄分为3组：年龄〈40岁组（37例）；年龄40-59岁组（47例）；年龄≥60岁组（19例）。比较各组腹膜透析前以及腹膜透析1、3个月的临床指标（收缩压、舒张压、体质量指数、RDW、血红蛋白、血白蛋白、血肌酐、血尿素氮等）的差异，采用多元线性回归分析腹膜透析患者的年龄和性别对RDW的影响。结果女性患者中RDW≥14．6％的患者所占比例在基线及腹膜透析1、3个月（13．5％、15．4%、17．3％）均高于男性患者（9．8％、7．8％、13．7％）。≥60岁年龄段的基线RDW较其他两个年龄组显著增高（P〈0．05）。年龄与基线RDW、腹膜透析1个月的RDW呈正相关（r=0．320、0．242，P〈0．05）。采用多元线性回归分析，并校正相应体质量指数后分析发现，女性（β=0．025，P〈0.001，95%CI^-0．001～0．953）和年龄较大（β=0．025，P〈0.001，95％CI 0．010～0．040）的患者基线RDW相对较高，同时年龄与腹膜透析1个月的RDW具有显著相关性（β=0．015，P〈0．05，95％CI 0．001～0．029）。进一步校正同期血红蛋白、血白蛋白和估算肾小球滤过率（或残肾肾小球滤过率）后发现，年龄与基线RDW（β=0．027，P〈0.001，95％CI 0．011～0.042）及腹膜透析1个月的RDW（β=0．017，P〈0．05，95％CI 0．003～O．031）仍具有显著相关性。结论RDW是影响透析患者预后的重要闪素；老年是RDW的影响因素，这为改善老年透析患者预后提供了新思路。

英文摘要：

Objective Red blood cell distribution width （RDW） has been proven to be an inde- pendent predictor of mortality in chronic hemodialysis patients. This study aimed to explore the char acteristics and influencing factors of the RDW in peritoneal dialysis patients. Methods The study en- rolled 103 uremic patients on CAPD. Patients were categorized into three groups according to their age （patients in group 1 were under the age of 40; group 2： aged between 40 and 59; group 3： aged above 60）. The differences of clinical parameters among three groups were analyzed, and the influence of age and gender on RDW was analyze by multiple linear regression. Results The proportion of subjects with RDW value above 14. 6% in female gender was higher than in male gender on the baseline, one month and three months after peritoneal dialysis （13.5%, 15.4%, 17. 3% vs. 9. 8%, 7. 8%,13. 7%）. The baseline RDW of the group 3 was significantly higher than that of the other groups. Age was positively associated with the RDW on the baseline and one month after dialysis. The multiple linear regression analysis revealed that after the corresponding BMI adjusted, the baseline RDW was associated with female gender （β = 0. 025, P〈0. 001, 95% CI - 0. 001 - 0. 953） and increasing age （β= 0. 025, P〈0. 001, 95% CI 0. 010 - 0. 040）, and RDW at one month after dialysis was related to the increasing age （fl = 0. 015, P〈0. 05, 95% CI 0. 001 - 0. 029）. After making further adjustments of hemoglobin, albumin and eGFR （or residual renal GFR）, increasing age remained associated with RDW on the baseline （β= 0. 027, P〈0. 001, 95% CI 0. 011 - 0. 042） and one month after dialysis （β= 0. 017, P〈0. 05, 95% CI 0. 003 - 0. 031）. Conclusions The influencing factors of RDW, and its mechanism of predicting dialysis patients＇ prognosis are not clear. This study found that the elevated RDW was associated with age, which provides a new insight to improve the prognosis of the elderly patients in peritoneal dialysis.