摘要
目的探讨红细胞分布宽度(red blood cell distribution width,RDW)对肺部感染所致脓毒症患者预后的评估价值。方法回顾性分析杭州师范大学附属医院2018年1-12月收治的80例肺部感染所致脓毒症患者,依据患病病情程度不同分为脓毒症组和脓毒症休克组。比较2组患者的急性生理与慢性健康状况评分(APACHEⅡ)及RDW水平,采用Pearson相关性分析研究APACHEⅡ评分及RDW之间的相关性,采用多因素logistic回归模型分析影响脓毒症预后的独立危险因素,采用ROC曲线分析预测价值。结果脓毒症休克组APACHEⅡ评分、RDW显著高于脓毒症组(均P<0.05);经相关性分析,RDW与APACHEⅡ评分呈正相关关系(r=0.015,P=0.001);脓毒症患者预后多因素logistic回归分析显示,APACHEⅡ、SOFA、PCT、RDW水平均是影响脓毒症患者预后的危险因素;通过PCT、APACHEⅡ、SOFA及RDW预测患者预后的ROC曲线可知,4项指标预估脓毒症患者预后的AUC分别为0.922、0.878、0.888、0.935,RDW与APACHEⅡ评分、SOFA评分、PCT的AUC比较差异无统计学意义(均P>0.05);RDW诊断的临界值为14.92%,APACHEⅡ评分诊断的临界值为16分,SOFA评分诊断的临界值为6分,PCT诊断的临界值为24.02 ng/mL。结论 RDW水平越高,脓毒症病情越严重,患者预后越差,其对脓毒症患者预后具有一定评估价值。
Objective To discuss the role of red blood cell distribution(RDW) in evaluating the prognosis of patients with sepsis caused by pulmonary infection. Methods Eighty patients with sepsis caused by pulmonary infection in the Affiliated Hospital of Hangzhou Normal University from January 2018 to December 2018 were retrospectively analyzed. They were divided into sepsis group and septic shock group according to the severity of the disease. The score of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) and RDW of the two groups were compared, the Pearson correlation coefficient is used to measure the strength of a linear association between between APACHE Ⅱ score and RDW. Multivariate logistic regression model was used to analyze the independent risk factors affecting the prognosis of sepsis. ROC curve was used to analyze the predictive value. Results APACHE Ⅱ score and RDW in the septic shock group were significantly higher than those in sepsis group(all P<0.05). There was a significant positive correlation between RDW and APACHE Ⅱ score(r=0.015, P<0.001). Logistic regression analysis of multiple prognostic factors in patients with sepsis showed that the levels of APACHE Ⅱ, SOFA, PCT and RDW were all important risk factors affecting the prognosis of patients with sepsis. The ROC curves of PCT, APACHE Ⅱ, SOFA and RDW to predict the prognosis of septic patients showed that the AUC of these four indexes were 0.922, 0.878, 0.888 and 0.935, respectively, and there was no significant difference among APACHE Ⅱ score, SOFA score and AUC of PCT(all P>0.05). The critical value of RDW diagnosis was 14.92% the critical value of APACHE Ⅱ score was 16 points, the critical value of SOFA score diagnosis was 6 points, and the critical value of PCT diagnosis was 24.02 ng/mL. Conclusion The higher the level of RDW, the more serious the sepsis condition, and the worse the prognosis of patients, which has certain evaluation value for the prognosis of sepsis patients.
作者
杨剑秋
毕建洲
YANG Jian-qiu;BI Jian-zhou(Department of ICU,the Affiliated Hospital of Hangzhou Normal University,Hangzhou,Zhejiang 310011,China;不详)
出处
《中华全科医学》
2020年第11期1827-1829,1915,共4页
Chinese Journal of General Practice
基金
浙江省自然科学基金(LY17H270058)。
关键词
红细胞分布宽度
脓毒症
预后
Red blood cell distribution width
Sepsis
Prognosis
