摘要
目的探讨红细胞分布宽度(RDW)和肺部感染严重程度评分(CURB-65评分)在老年肺部感染病人病情判断及预后评估中的临床应用价值。方法选择2014年1月至2015年12月收住我院呼吸科ICU的47例老年重症肺部感染病人为研究对象,另选择同期入住呼吸科的47例轻症肺部感染病人为对照组,记录2组对象入院后24 h内红细胞分布宽度(RDW)、白细胞计数(WBC)、降钙素原(PCT)、C反应蛋白(CRP)的水平;同时记录47例重症肺部感染病人入ICU后24 h内的CURB-65评分;采用Pearson相关分析对RDW和CURB-65评分进行相关性分析;采用二分类多变量Logistic回归分析筛选重症肺部感染相关的预后影响因素,绘制预测重症肺部感染病人预后的受试者工作特征(ROC)曲线。结果 (1)研究组RDW、PCT、CRP水平与对照组相比,差异有统计学意义(P<0.05),WBC水平与对照组相比,差异无统计学意义(P>0.05);重症肺部感染治疗有效组和治疗无效组相比,RDW、PCT、CRP水平差异有统计学意义(P<0.05)。(2)CURB-65评分与RDW呈正相关(r=0.49,P<0.01)。(3)多因素Logistic回归分析结果显示,RDW、PCT是重症肺部感染不良预后的独立危险因素。(4)根据绘制的ROC曲线,RDW预测重症肺炎预后的ROC曲线下面积(AUC)为0.734,界值为16.60%,RDW联合CURB-65评分的AUC为0.883。结论 RDW的测定值与老年肺部感染的严重程度密切相关,RDW和CURB-65评分联合应用对判断老年重症肺部感染预后有重要的参考价值。
Objective To explore the value of RDW and CURB-65 scoring system for predicting the prognosis and severity of elderly patients with severe pneumonia. Methods A total of 47 elderly patients with severe pneumonia in respiratory ICU from January 2014 to December 2015 were enrolled in this study. 47 elderly patients with mild pulmonary infection were enrolled as control group. The levels of red blood cell distribution width （ RDW）, white blood cell （ WBC ） count, procaleitonin （ PCT）, C reactive protein（CRP） were measured within 24 hours of admission. The score of CURB-65 about the 47 patients with severe pneumonia were recorded. The correlation between RDW and CURB-65 score were analyzed by Pearson correlation analysis. Logistic regression analysis was performed to determine the risk factors formortality. Receiver operator curve （ ROC ） test was used to evaluate the predictive value of RDW and CURB-65 for hospital death. Results （1） The levels of RDW, PCT, CRP showed statistical differences between the research group and the control group（P〈0.05）; While WBC count of the two groups showed no statistical differences （P〉0.05） ; The level of RDW was statistically different between the group with effective treatment and group with invalid treatment （P〈 0. 05 ）; （2） RDW was significantly correlated with CURB-65 score （ r= 0.49, P〈0.01 ） ; （ 3 ） Logistic regression showed that RDW and PCT were independently associated with bad prognosis; （4） The best cut-off value was 16.60% for RDW. The area under curve（AUC） by RDW was 0. 734, and the AUC by RDW and CURB- 65 scoring system was 0. 883. Conclusions RDW level correlates with the severity of pulmonary infection, and the RDW level and CURB-65 scoring system have an additional predictive value for the prognosis of elderly patients with severe pneumonia.
出处
《实用老年医学》
CAS
2017年第8期743-746,共4页
Practical Geriatrics
基金
2015年江苏省干部保健科研课题(BJ15018)
