红细胞分布宽度对急性重症胰腺炎患者院内死亡的预测价值  

The Clinic value of red blood cell distribution in predicting of in-hospital deaths of the patients with severe acute pancreatitis

作　　者：陈南[1] 陆士奇[1] 

机构地区：[1]苏州大学附属第一医院急诊科,江苏苏州215006

出　　处：《中国急救医学》2015年第8期715-718,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的：探讨红细胞分布宽度（ red blood cell distribution width， RDW）对急性重症胰腺炎（ severe acute pancreatitis， SAP）患者院内死亡的预测价值。方法95例SAP患者，按住院期间是否死亡分为死亡组和非死亡组。分析两组患者的基本临床资料，通过二分类Logistic回归分析得出院内死亡的危险因素，绘制ROC曲线，分析RDW对SAP患者院内死亡的预测价值。结果死亡组的血糖、血钙、血肌酐、氧合指数、白蛋白、乳酸脱氢酶、血红蛋白、红细胞压积、RDW、APACHEⅡ评分与Ranson 评分等指标与非死亡组比较差异有统计学意义（ P＜0．05）；二分类Logistic回归分析显示，RDW、APACHEⅡ评分、Ranson 评分、白蛋白、氧合指数、血肌酐等指标为院内死亡的独立危险因素（P ＜0．05）；ROC 曲线分析显示，RDW 曲线下面积为0．907（95％CI 0．928-0．968，P＝0．000），APACHEⅡ评分为0．864（95％CI 0．812-0．915，P＝0．000），氧合指数为0．848（95％CI 0．785-0．833，P＝0．001）。结论 RDW是SAP患者预后的独立预测因子，对SAP患者院内死亡的预测价值较高。Objective To investigate red blood cell distribution width （ RDW） predictive value of in-hospital deaths in patients with severe acute pancreatitis （ SAP） .Methods Ninety-five SAP patients, according to whether hospitalization death were divided into death and non -death group. Analysis on the basic clinical data of two groups of patients.The risk factors of in-hospital deaths were classified by binary logistic regression analysis.RDW predictive value of in-hospital deaths in patients with SAP was analyzed by drawing ROC curve. Results The differences of glucose, calcium, creatinine, oxygenation index, albumin, lactate dehydrogenase, hemoglobin, red blood cells deposit, RDW and APACHEⅡscore, Ranson score between death group and non-death group were statistically significant （P〈0.05）.Binary classification logistic regression analysis showed that RDW, APACHEⅡscore, Ranson score, albumin, oxygenation index, creatinine were independent risk factors for in -hospital deaths （P 〈0.05）; the RDW regression coefficient was 0.156, and odds ratio （OR） was 1.170 （95%CI 1.004-1.325, P=0.008）.ROC curve analysis showed that the area under the curve of RDW was 0.907 （95%CI 0.928 -0.968, P=0.000）; APACHEⅡ score was 0.864 （95%CI 0.812-0.915, P=0.000）, and oxygenation index was 0.848 （95%CI 0.785-0.833, P=0.001）. Conclusion RDW is an independent predictor of prognosis in patients with SAP, and has higher predictive value to SAP patients of in-hospital deaths.

关 键 词：红细胞分布宽度(RDW) 急性重症胰腺炎(SAP) ROC曲线 

分 类 号：R657.51[医药卫生—外科学]