红细胞分布宽度对重症急性胰腺炎患者院内死亡的预测价值  

Clinical value of red blood cell distribution Width in predicting in-hospital death of patients with severe acute pancreatitis

作　　者：杨涓[1] 郑盛[1] 刘汉屈[1] 唐映梅[2] 

机构地区：[1]云南省第三人民医院消化内科,云南省昆明市650011 [2]昆明医科大学附属第二医院肝病中心,云南省昆明市650000

出　　处：《世界华人消化杂志》2016年第2期305-310,共6页World Chinese Journal of Digestology

基　　金：云南省自然科学基金资助项目;No.2012FD095; 云南省教育厅科研基金重点资助项目;Nos.2014Z125;2015Z146

摘　　要：目的：探讨红细胞分布宽度（red blood cell distribution width,RDW）对重症急性胰腺炎（severe acute pancreatitis,SAP）患者院内死亡的预测价值.方法：回顾性选择2013-01/2015-06云南省第三人民医院收治的SAP患者114例纳入研究,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、APAPHEⅡ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、APAPHEⅡ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）,APAPHEⅡ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患者预后的对立预测因子,对SAP患者院内死亡的预测价值较高.AIM： To investigate the value of red blood cell distribution width （RDW） in predicting in- hospital death of patients with severe acute pancreatitis （SAP）. METHODS： One hundred and fourteen SAP patients were divided into either a death or a non-death group, according to whether hospitalization death occurred. Clinical data for the two groups of patients were analyzed. The risk factors for in-hospital death were classified by binary logistic regression analysis. The value of RDW in predicting in-hospital death in patients with SAP was assessed by ROC curve analysis. RESULTS： The differences in glucose, calcium, creatinine, oxygenation index, albumin, lactate dehydrogenase, hemoglobin, red blood cells deposit, RDW, APACHEII score, and Ranson score between the death group and non- death group were statistically significant （P 〈 0.05）. Binary classification logistic regression analysis showed that RDW, APACHEII score,Ranson score, albumin, oxygenation index, and creatinine were independent risk factors for in-hospital death （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 was 0.907 for RDW （95%CI： 0.928-0.968, P = 0.000）; 0.864 for APACHEII score （95%CI： 0.812-0.915, P = 0.000）; and 0.848 for oxygenation index （95%CI： 0.785-0.833, P -- 0.001）. CONCLUSION： RDW is an independent predictor of prognosis in patients with SAP, and has high value in predicting in-hospital death of SAP patients.

关 键 词：红细胞分布宽度 重症急性胰腺炎 ROC曲线 预后 

分 类 号：R657.51[医药卫生—外科学]