红细胞分布宽度在脓毒性休克患者中的变化研究  

Study on the change of red cell distribution width in patients with septic shock

作　　者：王国粉 杨肖蓉[1] 任婵[1] 苏瑜 王英[1] 

机构地区：[1]昆明医科大学第一附属医院重症医学科,云南昆明650032

出　　处：《安徽医药》2018年第2期257-260,共4页Anhui Medical and Pharmaceutical Journal

基　　金：云南省科技厅资金项目(2014FZ013;2015FB050);云南省教育厅科学研究基金项目(2014C050Y)

摘　　要：目的观察红细胞分布宽度(RDW)在脓毒性休克患者中的变化情况及其临床应用价值。方法将研究对象分为脓毒性休克组(脓毒性休克组又分为死亡组和存活组)、脓毒症组和健康对照组,观察各组患者的RDW水平,同时与C反应蛋白(CRP)、降钙素原(PCT)、动脉血乳酸(Lac)、急性生理与慢性健康评分(APACHEⅡ)和序贯器官衰竭估计评分(SOFA)等进行相关性分析。结果脓毒性休克组、脓毒症组患者RDW明显高于健康对照组(P<0.05)。与存活组相比,死亡组入院后1、3、5、7、10 d的RDW升高(P<0.05)。入院第1个24 h脓毒性休克组RDW与CRP、PCT、APACHEⅡ评分和SOFA评分成正相关性(r=0.836,0.683,0.589,0.727,0.311,P<0.05)。RDW与APACHEⅡ评分和SOFA评分联合可以提高脓毒性休克患者的死亡预测能力。结论 RDW水平升高对脓毒症具有预示作用,同时对脓毒性休克患者不良预后具有判断作用。Objective To observe the changes of red cell distribution width(RDW)in patients with septic shock and its clinical application value. Methods All cases were divided into sepsis shock group( septic shock were divided into death group and survival group),sepsis group and the healthy control group,The RDW levels of patients in each group were observed,and the correlation was analyzed with C reactive protein( CRP),calcitonin( PCT),arterial blood lactic acid(Lac), APACHE Ⅱ score and SOFA score. Results RDW in septic shock group and sepsis group were significantly higher than that in healthy control group,(P < 0. 05). Compared with the survival group, 1,3,5,7 d, RDW, 10 d of the death group were increased(P < 0.05). In the first 24 h, septic shock group RDW and CRP,PCT,APACHE Ⅱ score,SOFA score had a positive correlation(r = 0. 836,0.683,0. 589,0. 727,0. 311,P <0.05). The combination of RDW with APACHE Ⅱ score and SOFA score can improve the predictive ability of death in patients with septic shock. Conclusion The elevated RDW levels have a predictive effect on sepsis, and can determine the adverse outcomes in patients with septic shock.

关 键 词：红细胞分布宽度 脓毒性休克 变化研究 

分 类 号：R459.7[医药卫生—急诊医学]