Platelet index levels and cardiovascular mortality in incident peritoneal dialysis patients: a cohort study
Platelet index levels and cardiovascular mortality in incident peritoneal dialysis patients: a cohort study
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腹膜透析患者的血小板指数水平和心血管死亡率：一项队列研究
DOI：
10.1080/09537104.2016.1246716
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发表时间：
2017-01-01
期刊：
影响因子：
3.3
通讯作者：
Yang, Xiao
中科院分区：
文献类型：
--
作者：
Peng, Fenfen;Li, Zhijian;Yang, Xiao
摘要既往研究表明，血液透析患者的某些血小板（PLT）指标与死亡率相关。我们的目的是研究血小板指标的变化是否与腹膜透析（PD）患者的死亡率相关。在2006年1月1日至2012年12月31日期间发生PD的患者中进行了一项单中心、回顾性观察性队列研究，并随访至2014年12月31日。采用考克斯比例风险模型分析PLT、血小板压积（PCT）、平均血小板体积（MPV）、血小板分布宽度（PDW）、血小板大细胞比率（PLCR）等指标水平与死亡率的关系。在1324例患者中，276例（20.8%）在随访期间死亡（中位数，37; IQR，3-107.4个月），其中134例死于心血管疾病（CVD）。校正人口统计学、临床特征和实验室变量后，基线时PLT水平的最高三分位数与心血管死亡风险增加相关（风险比[HR]：1.93; 95%置信区间[CI]：1.16-3.20）。在PCT水平的中间和最高三分位数中也观察到类似的趋势（HR：1.68，95%CI：1.00-2.81和HR：1.89，95%CI：1.14-3.14）。此外，PCT的最高三分位数与全因死亡率增加相关（HR：1.41，95%CI：1.01-1.96）。然而，MPV、PDW和PLCR分析中的相关性均未达到统计学显著性（分别为HR：0.71，95%CI：0.43-1.16; HR：0.72，95%CI：0.45-1.18和HR：0.74，95%CI：0.46-1.19）。这些结果表明，较高的PLT和PCT可能与事件PD患者的心血管死亡风险较高相关。需要进一步的研究来调查这两个PLT指数的校正是否会降低风险。
Abstract Prior studies have shown that the levels of some platelet (PLT) indices were associated with mortality in patients undergoing hemodialysis. We aimed to investigate whether the changes in PLT indices associated with mortality in patients on peritoneal dialysis (PD). A single-center, retrospective observational cohort study was conducted in incident PD patients from 1 January 2006 to 31 December 2012, and followed up until 31 December 2014. Cox proportional hazard models were used to examine the relationships between the levels of PLT indices including PLT, plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (PLCR), and mortality. Of 1324 patients, 276 (20.8%) died during follow-up (median, 37; IQR, 3–107.4 months), among which 134 were due to cardiovascular diseases (CVD). The highest tertile of PLT levels at baseline was associated with increased risk for cardiovascular mortality after adjustment for demographic, clinical characteristics, and laboratory variables (hazard ratio [HR]:1.93; 95% confidence interval [CI]: 1.16–3.20). The similar treads were also observed in the middle and the highest tertile of the PCT level (HR: 1.68, 95%CI: 1.00–2.81 and HR: 1.89, 95%CI: 1.14–3.14, respectively). In addition, the highest tertile of PCT was associated with increased all-cause mortality (HR: 1.41, 95%CI: 1.01–1.96). However, none of the associations in MPV, PDW, and PLCR analyses reached statistical significance (HR: 0.71, 95%CI: 0.43–1.16; HR: 0.72, 95%CI: 0.45–1.18 and HR: 0.74, 95%CI: 0.46–1.19, respectively). These results suggest that higher PLT and PCT may be associated with higher risk for cardiovascular mortality in incident PD patients. Additional studies are needed to investigate whether correction of these two PLT indices reduces the risk.