摘要
目的探讨嗜酸性粒细胞绝对值与红细胞分布宽度(RDW)比值(EOR)对急性呼吸窘迫综合征(ARDS)预后的预测价值。方法利用重症医学信息数据库(版本1.0)提取2008至2019年贝斯以色列女执事医疗中心ICU收治的610例ARDS患者临床资料。根据入住ICU 28 d转归情况分为存活组502例,死亡组108例。比较两组患者性别、年龄、ARDS危险因素、入住ICU第1个24 h内的实验室检测结果[主要包括乳酸、尿素氮、血肌酐、碳酸氢盐、阴离子间隙(AG)、RDW、嗜酸性粒细胞绝对值、EOR等];采用单因素和多因素Cox回归模型分析ARDS患者28 d死亡的影响因素;采用ROC曲线分析EOR单独或联合AG、年龄预测ARDS患者28 d死亡的效能。结果死亡组患者年龄以及乳酸、尿素氮、血肌酐、AG、RDW均明显高于存活组,碳酸氢盐、嗜酸性粒细胞绝对值和EOR均明显低于存活组,差异均有统计学意义(均P<0.05)。年龄(HR=1.02)、AG(HR=1.07)、RDW(HR=1.13)、EOR(HR=0.52)是ARDS患者28 d死亡的独立影响因素(均P<0.05)。EOR单独、EOR+AG、EOR+AG+年龄预测ARDS患者28 d死亡的AUC分别为0.636(95%CI:0.582~0.691,P<0.05)、0.702(95%CI:0.649~0.754,P<0.05)、0.729(95%CI:0.676~0.782,P<0.05)。结论EOR是ARDS患者28 d死亡的独立影响因素,其联合AG、年龄对患者预后具有较高的预测价值。
Objective To investigate the predictive value of the absolute eosinophil to red blood cell distribution width(RDW)ratio(EOR)on the prognosis of acute respiratory distress syndrome(ARDS).Methods Clinical data of 610 patients with ARDS admitted to the ICU of Beth Israel Deaconess Medical Center from 2008 to 2019 were extracted using a large critical care database,Medical Information Mart for Intensive Care(version 1.0).They were categorized into the survival group(n=502)and the death group(n=108)based on the outcome after 28 days of ICU admission.The two groups were compared in terms of gender,age,ARDS risk factors,and laboratory test results during the first 24 h of admission to the ICU[mainly including lactate,urea nitrogen,blood creatinine,bicarbonate,anion gap(AG),RDW,absolute eosinophil count,EOR,etc.];the influencing factors of ARDS patients'28-d mortality were analyzed by using univariate and multivariate Cox regression models;ROC curves were used to analyze the efficacy of EOR alone or in combination with AG and age in predicting 28-d mortality of ARDS patients.Results The age,as well as levels of lactate,urea nitrogen,blood creatinine,AG,and RDW in the death group,were significantly higher than those of the survival group,while the levels of bicarbonate,absolute eosinophil count,and EOR were significantly lower than those of the survival group,and the differences were all statistically significant(all P<0.05).Age(HR=1.02),AG(HR=1.07),RDW(HR=1.13),and EOR(HR=0.52)were independent influencing factors for 28-d mortality of ARDS patients(all P<0.05).The AUCs of EOR alone,EOR+AG,and EOR+AG+age for predicting 28-d mortality of ARDS patients were 0.636(95%CI:0.582-0.691,P<0.05),0.702(95%CI:0.649-0.754,P<0.05),and 0.729(95%CI:0.676-0.782,P<0.05),respectively.Conclusion EOR is an independent influencing factor of 28-d mortality of ARDS patients,and its combination with AG and age has a high predictive value for patients'prognosis.
作者
廖清波
普玉凡
靳小二
王淼
丁琦
LIAO Qingbo;PU Yufan;JIN Xiaoer;WANG Miao;DING Qi(Department of Emergency,Suzhou Municipal Hospital,Suzhou 215000,China)
出处
《浙江医学》
CAS
2023年第21期2298-2302,共5页
Zhejiang Medical Journal
基金
姑苏人才培养项目(GSWS2020065)。
关键词
急性呼吸窘迫综合征
嗜酸性粒细胞绝对值
红细胞分布宽度
预测价值
Acute respiratory distress syndrome
Absolute eosinophil count
Red blood cell distribution width
Predictive value
