PDAP患者RDW D-D miR-216a-5p与SIRI的关系及对预后的预测价值分析

doi:10.3969/j.issn.1006-6233.2025.01.015

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Abstract Objective: To analyze the correlation between red blood cell distribution width (RDW), D-dimer (D-D), microRNA-216a-5p (miR-216a-5p) and baseline systemic inflammation response index (SIRI) in patients with peritoneal dialysis-associated peritonitis (PDAP), and their predictive value for prognosis. Methods: One hundred and eighty PDAP patients visited in our hospital from January 2020 to January 2024 were recruited and divided into a poor prognosis group (n=42) and a good prognosis group (n=138) based on their short-term prognosis. Pearson analysis was conducted to analyze the correlation between RDW, D-D, miR-216a-5p with SIRI. Logistic regression was performed to assess the influencing factors of prognosis in PDAP patients. Receiver operating characteristic (ROC) curve was drawn used to analyze the predictive power of RDW, D-D, miR-216a-5p and SIRI on the prognosis of PDAP patients. Results: Compared with the group with good prognosis, the group with poor prognosis had significantly increased peripheral blood RDW, D-D, and SIRI, and the differences were statistically significant (t=15.958, 29.928, 22.490, all P<0.05). Compared with the group with good prognosis, the miR-216a-5p in peripheral blood of the group with poor prognosis was significantly reduced, and the difference was statistically significant (t=22.041, P<0.05). RDW, D-D were positively correlated with SIRI (r=0.498, 0.481, all P<0.05), while miR-216a-5p was negatively correlated with SIRI (r=-0.507, P<0.05). Logistic regression showed that RDW (OR [95% CI]: 2.125 [1.045-4.392]), D-D (OR [95% CI]: 1.984 [1.134-3.584]), miR-216a-5p (OR [95% CI]: 3.924 [1.399-5.267]), SIRI (OR [95% CI]: 2.684 [1.284-3.569]), ALB (OR [95% CI]: 1.813 [1.064-3.284]), CRP (OR [95% CI]: 2.007 [1.052-4.006]) were risk factors for poor prognosis in PDAP patients (all P<0.05). The area under the curve (AUC) for predicting poor prognosis in PDAP patients using combined detection of peripheral blood RDW, D-D, miR-216a-5p, and SIRI is 0.870, with a 95% confidence interval of 0.819~0.937. The AUC of combined detection of peripheral blood RDW, D-D, miR-216a-5p, and SIRI is higher than that of single detection, and the difference is statistically significant (Z/P=2.812/0.008, 2.605/0.014, 2.411/0.010, 2.701/0.017). Conclusion: There is a certain correlation between RDW, D-D, miR-216a-5p with SIRI in PDAP patients. Elevated RDW, D-D, and decreased miR-216a-5p are closely related to the prognosis of patients, and the combined detection of RDW, D-D, miR-216a-5p, with SIRI has a high predictive effect on the prognosis of PDAP patients.

Key words： Peritoneal dialysis Peritonitis Red blood cell distribution width D-dimer MicroRNA-216a-5p Baseline systemic inflammatory response index Prognosis

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2025.01.015 OR http://www.hbyxzzs.cn/EN/Y2025/V31/I1/84

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