急性呼吸窘迫综合征患者血乳酸和红细胞分布宽度与病情严重程度的相关性分析  

Correlation analysis between serum lactic acid and red blood cell distribution width and disease severity in patients with acute respiratory distress syndrome

作　　者：叶阳[1] 周瑞卿 胡志强 Ye Yang;Zhou Rui-qing;Hu Zhi-qiang(Department of Emergency, the First Affiliated Hospital, Baotou Medical College, Inner Mongolia University of Science ＆ Technology, Baotou 014010, China)

机构地区：[1]内蒙古科技大学包头医学院第一附属医院急诊科,内蒙古包头014010

出　　处：《中国急救医学》2018年第6期481-484,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨急性呼吸窘迫综合征（acute respiratory distress syndrome, ARDS）患者血乳酸（lactic acid, LAC）和红细胞分布宽度（red blood cell distribution width, RDW）与病情严重程度的相关性。方法 选取2015-07～2017-07我院收治的ARDS患者64例为观察组，56例健康体检者为对照组。于入院时，抽取两组桡动脉血进行血气分析。观察组患者按氧合指数（PaO2/FiO2）分为轻度（30例）、中度（22例）和重度（12例）三个亚组。分别测定两组LAC值。采集两组外周静脉血进行血常规检测，测定RDW。观察组LAC和RDW与ARDS病情严重程度的相关性采用Pearson相关分析。结果 观察组LAC和RDW［（5.86±2.32）mmol/L, （16.42±2.96）%］均高于对照组［（0.94±0.23）mmol/L, （12.15±1.48）%］，差异均有统计学意义（P〈0.05）。重度组LAC和RDW［（9.36±3.23）mmol/L, （21.56±3.38）%］，中度组LAC和RDW［（6.74±2.65）mmol/L, （16.74±3.02）%］均高于轻度组［（2.42±0.84）mmol/L, （12.32±2.45）%］，差异均有统计学意义（P〈0.05）。重度组LAC和RDW［（9.36±3.23）mmol/L, （21.56±3.38）%］高于中度组LAC和RDW［（6.74±2.65）mmol/L, （16.74±3.02）%］，差异均有统计学意义（P〈0.05）。Pearson相关分析显示，LAC与PaO2/FiO2之间呈负相关（r=-0.742, P＜0.05）。RDW与PaO2/FiO2之间呈负相关（r=-0.848, P＜0.05）。结论 ARDS患者存在LAC和RDW升高。Pearson相关分析显示，LAC和RDW与PaO2/FiO2之间均呈负相关，即与ARDS病情严重程度均呈正相关。提示LAC和RDW均是ARDS病情严重程度的重要指标，可为临床评价ARDS病情严重程度提供重要的参考价值。Objective To observe the levels of serum lactic acid （LAC） and red blood cell distribution width （RDW） in patients with acute respiratory distress syndrome （ARDS） and correlation analysis with severity. Methods 64 patients with ARDS were selected as the observation group enrolled from July 2015 to July 2017. At the same time, 56 health examinations were collected as the control group. Two groups of radial artery blood were extracted for blood gas analysis at admission. The patients in the observation group were divided into the mild （n=30）, the moderate （n=22） and the severe （n=12） three subgroups according to the oxygenation index （PaO2/FiO2）. The LAC levels of the two groups were measured respectively. Two groups of peripheral venous blood were collected for blood routine test, and RDW was measured. The correlation between the levels of LAC and RDW in the observation group and the severity of ARDS was analyzed by Pearson correlation analysis. Results The levels of LAC and RDW [（5.86±2.32）mmol/L, （16.42±2.96）%] in the observation group were higher than those in the control group [（0.94±0.23） mmol/L, （12.15±1.48）%], the differences were both statistically significant （P〈0.05）. The levels of LAC and RDW [（9.36±3.23） mmol/L, （21.56±3.38）%] in the severe group, the levels of LAC and RDW [（6.74±2.65） mmol/L, （16.74±3.02）%] in the moderate group were higher than those in the mild group [（2.42±0.84） mmol/L, （12.32±2.45）%], the differences were all statistically significant （P〈0.05）. The levels of LAC and RDW [（9.36±3.23） mmol/L, （21.56±3.38）%] in the severe group were higher than those in the moderate group [（6.74±2.65） mmol/L, （16.74±3.02）%], the differences were all statistically significant （P〈0.05）. Pearson correlation analysis showed that the levels of LAC were negative correlated with PaO2/FiO2 （r=-0.742,P〈0.05）, the levels of RDW were negative correlated with PaO2/FiO2（r=-0.848, P〈0

关 键 词：急性呼吸窘迫综合征(ARDS) 血乳酸(LAC) 红细胞分布宽度(RDW) 病情严重程度 相关性分析 

分 类 号：R563.8[医药卫生—呼吸系统]