社区获得性肺炎患者的预后与红细胞分布宽度的相关性  

Relationship between red blood cell distribution width and prognosis in patients with community acquired pneumonia

作　　者：费斯 王飞 姜婷婷 徐峰 蔡杰丰 胡善友 

机构地区：[1]上海市嘉定区迎园医院,上海201800 [2]上海市嘉定区中心医院,上海201800

出　　处：《临床肺科杂志》2015年第8期1391-1394,共4页Journal of Clinical Pulmonary Medicine

基　　金：上海市嘉定区卫生系统第三批重点学科建设项目(No ZD01);上海市嘉定区卫生局青年科研项目(No 2013-QN-02)

摘　　要：目的探讨社区获得性肺炎(CAP)患者的红细胞分布宽度(RDW)与其严重程度及预后的相关性。方法连续性选择2011年7月至2013年7月间,收住上海市嘉定区中心医院急诊科的CAP患者260例,根据RDW是否高于参考值的正常上限分为两组,分别为正常组RDW≦14.5%(n=208)和异常组RDW>14.5%(n=52),比较两组患者的临床资料、实验值指标、PSI(pneumonia severity index,肺炎严重程度)评分分级及病死率的差异性;再根据PSI评分及预后,比较不同PSI级别和不同预后的RDW异常率的差异;采用Spearman相关分析对RDW及PSI评分进行相关分析。结果 RDW异常组发生重症率(46.2%vs 24.5%,P=0.003)、PSI IV-V级(53.8%vs 22.1%,P<0.001)及病死率(15.4%vs 4.3%,P=0.009)显著高于正常组;RDW异常率随着PSI评分级别增高而增高(9.67%vs 16.13%vs 36.23%vs 60%,P<0.001);死亡组发生RDW异常率(18.11%vs 47.06%,P=0.009)显著高于存活组;PSI评分与RDW呈显著正相关(r=0.210,P=0.001)。结论 CAP患者的RDW水平与其严重程度密切相关,RDW>14.5%对其预后有重要的参考价值。Objective To explore the relationship between red blood cell distribution width （RDW） and the severity and prognosis in patients with community acquired pneumonia （CAP）. Methods From July 2011 to July 2013, a total of 260 CAP patients in the Emergency Department of Jiading District Central Hospital were enrolled in the study. Based on the RDW level, the patients were divided into two groups as the normal-RDW group （≤14. 5% , n = 208） and the abnormal-RDW group （ 〉 14. 5% , n = 52）. Differences in clinical data, Laboratory indexes, pneumonia severity index （PSI） score and mortality were compared between the two groups. Then the rate of abnor-mal RDW level was compared between the groups according to the PSI and the prognosis. The correlation between RDW level and PSI score was analyzed by Spearman correlation test. Results The proportion of severe patients （46. 2% vs 24. 5% , P = 0. 003）, the level of PSI IV-V （53. 8% vs 22. 1% , P 〈 0. 001） and the mortality （15. 4%vs 4. 3% , P = 0. 009） were significant higher in the abnormal-RDW group than in the normal-RDW group. With the elevated level of PSI, the rate of abnormal RDW increased （9. 67% vs 16. 13% vs 36. 23% vs 60% , P 〈 0. 001）. And the rate in the death group was significant higher than that in the survival group （18. 11% vs 47. 06% , P =0. 009）. PSI score was significantly correlated with RDW level （r = 0. 210, P = 0. 001）. Conclusion The level of RDW is closely related with the severity in community acquired pneumonia patients. RDW 〉 14. 5% has important reference value to the prognosis in CAP.

关 键 词：红细胞分布宽度 社区获得性肺炎 PSI评分 预后 

分 类 号：R563.1[医药卫生—呼吸系统]