红细胞分布宽度与成人社区获得性肺炎严重程度的相关性分析  

Correlation analysis of red blood cell distribution width and disease severity of adult patients with community-acquired pneumonia

作　　者：张静[1] 刘冬[2] 许西琳[2] 赵越[1] 辛雯艳 ZHANG Jing1, LIU Dong2, XU Xilin2, ZHAO Yue1, XlN Wenyan2(1. Medical College of Shihezi University, Shihezi, Xinjiang 832000, P. R. China 2. Department of Respiratory Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832000, P. R. Chin)

机构地区：[1]石河子大学医学院,新疆石河子832000 [2]石河子大学医学院第一附属医院呼吸内科,新疆石河子832000

出　　处：《中国呼吸与危重监护杂志》2018年第2期134-137,共4页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：兵团科技攻关项目(2010GG47);科技支疆计划项目(2014AB030)

摘　　要：目的探讨红细胞分布宽度(red blood cell distribution width,RDW)与成人社区获得性肺炎(community-acquired pneumonia,CAP)病情严重程度的相关性。方法收集2014年11月至2017年8月石河子大学医学院第一附属医院住院的285例成人CAP患者的病历资料。用肺炎严重度指数(pneumonia severity index,PSI)对CAP病情严重度进行评估,将患者分为低危、中危和高危三组。收集同期门诊体检检查结果合格的60例就诊者为健康对照组。描述不同危险度分层PSI分数、RDW值、降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)和中性粒细胞百分比(NEU%)的分布。用Spearman相关性分析各指标的相关关系。通过一般线性回归构建方程,计算RDW(%)的阈值,用多元线性回归分析PSI分数的影响因素。结果危险度分层越高,PSI分数越高,RDW值越高,PCT值越高,CRP值越高,NEU%值越高。RDW与PCT、CRP、NEU%呈正相关(r值分别为0.417、0.252、0.318,均P<0.05)。PSI分数与RDW、PCT、CRP、NEU%呈正相关(r值分别为0.537、0.598、0.557、0.482,均P<0.05)。RDW与PSI评分呈正相关(r=0.537,P<0.05)。RDW(%)的阈值分别为14.514、19.041。多元线性回归分析显示RDW、PCT、CRP、NEU%均是PSI分数的影响因素,解释了PSI分数变异率的46.9%。结论 RDW与CAP病情严重程度有关,可以预测CAP严重程度。Objective To investigate the relationship between the red blood cell distribution width （RDW） and the severity of community-acquired pneumonia （CAP）. Methods The clinical data of 285 adult patients with CAP admitted from November 2014 to August of 2017 were analyzed retrospectively. The severity of CAP was evaluated by pneumonia severity index （PSI） score. Meanwhile, 60 cases with qualified medical examination were collected as a healthy control group. The distributions of PSI score, RDW, procalcitonin （PCT）, C-reactive protein （CRP） and neutrophil percentage （NEU%） were described in the patients with different risk degree. The correlation analysis of various indicators were analyzed by Spearman correlation. The threshold of RDW（%） was calculated through the construction of the general linear regression equation. The risk factors of PSI score were analyzed with multiple linear regression. Results The higher the risk stratification, the higher the distribution of PSI scores, RDW, PCT, CRP and NEU% were. RDW was positively correlated with PCT, CRP, and NEU% （r values were 0.417, 0.252, 0.318, respectively, P〈0.05）. PSI score was positively correlated with RDW, PCT, CRP, and NEU% （r values were 0.537,0.598, 0.557, 0.482, respectively, P〈0.05）. RDW was positively correlated with PSI score （r=0.537, P〈0.05）. The thresholds of RDW（%） were 14.514 and 19.041. Multiple linear regression showed that RDW, PCT, CRP and NEU% were all influential factors of PSI scores and explained 46.9% of the total mutation rate. Conclusion RDW is correlated with the severity of CAP, and can predict the severity of CAP.

关 键 词：社区获得性肺炎 严重度分层 红细胞分布宽度 相关性分析 

分 类 号：R563.1[医药卫生—呼吸系统]