RDW预测急性脑出血患者30天死亡风险的研究  

Predicting 30-day mortality of acute cerebral hemorrhage with red blood cell volume distribution width

作　　者：黄钰财 李劈正 彭文[3] 

机构地区：[1]长沙市中心医院神经内科,长沙410004 [2]湘潭县人民医院神经内科 [3]中南大学湘雅二医院急诊科

出　　处：《中国急救复苏与灾害医学杂志》2017年第12期1142-1144,共3页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：湖南省科技计划项目（2015SF2045）

摘　　要：目的探讨红细胞体积分布宽度（red blood cell volume distribution width，RDW）和急性脑出血患者30d死亡风险的关系。方法按纳入和排除标准回顾性分析2012年3月-2016年3月湘潭县人民医院神经内科收治的急性脑出血患者，按30d内有无发生死亡分为存活组与死亡组，登记相关病史、入院后的首次血常规、相关生化指标和CT情况，多因素回归分析分析急性脑出血院内死亡的独立危险因素，ROC曲线分析RDW预测院内死亡的价值。结果纳入的269例急性脑出血患者中，30d内发生死亡为64例（23．8％）；死亡组的RDW水平显著高于存活组（13．8％±0．62vs12．6％±0.51，P=0．000）；析因分析后RDW是院内死亡的独立危险因素（OR=1．864，P=0．003）；RDW预测急性脑出血患者院内死亡的ROC曲线下面积为0．729，P〈0．05，当RDW为13．25％时，预测的灵敏度为0．778，特异度为0．694。结论RDW对于急性脑出血患者的院内死亡具有一定的预测作用。Objective To explore the relationship between red blood cell volume distribution width （RDW） and 30-day mortality of acute cerebral hemorrhage. Methods The records were reviewed（including the first admitted history, the blood routine test, other biomarkers and CT result） for patients admitted to the large comprehensive university hospital due to acute cerebral hemorrhage from March I, 2012 to March, 2016 .The patients were divided into two groups： group Ⅰ-survival 〉30 days after 30 days＇ treatment and group Ⅱ-death 〈30days.. Using multivariable logistic regression analysis to identify the independent risk factor of death up to 30days. Then performed ROC curve analysis to assess the predictive value of the risk factor. Results 64（23.8% ） died in all enrolled 269 patients with acute cerebral hemorrhage,. RDW values in death group are significantly higher than that in survival group （ 13.8%±0.62 vs 12.6%± 0.51, P =0.000） ; RDW is an independent risk fact of 30-day mortality （OR=1.864, P =0.003） ;The area under ROC curve is 0.729, P 〈0.05, and when RDW=13.25%, the sensitivity is 0.778 and specificity is 0.694. Conclusions RDW has a certain predictive effect on the risk of 30-day mortality of acute cerebral hemorrhage.

关 键 词：红细胞体积分布宽度 急性脑出血 30 d死亡风险 

分 类 号：R183[医药卫生—流行病学]