红细胞分布宽度在呼吸机相关肺炎患者预后中的评估价值  

Predictive value of red cell distribution width on the prognosis of patients with ventilator-associated pneumonia

作　　者：申良红[1] 刘米莉 王凤霞[2] SHEN Lianghong;LIU Mili;WANG Fengxia(Xinjiang Emergency Center,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院新疆急救中心,新疆乌鲁木齐830001 [2]新疆维吾尔自治区人民医院心脏内科,新疆乌鲁木齐830001

出　　处：《皖南医学院学报》2021年第2期129-131,共3页Journal of Wannan Medical College

基　　金：新疆维吾尔自治区自然科学基金项目(2018D01C322)。

摘　　要：目的:探讨红细胞分布宽度(RDW)对呼吸机相关肺炎(VAP)患者预后的评估价值。方法:回顾性分析2019年1~12月入住新疆维吾尔自治区人民医院急救中心监护室并发VAP患者的临床资料,根据28 d预后将患者分为生存组和死亡组。收集患者一般资料,记录入ICU 24 h内各项实验室指标,比较两组RDW、血乳酸(Lac)、降钙素原(PCT)、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、机械通气时间、ICU治疗时间,绘制受试者工作特征曲线(ROC),评估Lac、PCT、RDW和APACHEⅡ评分对患者预后的预测价值。结果:本研究共纳入VAP患者79例,死亡组患者机械通气时间[(8.50±2.19)d]高于生存组患者[(6.25±1.46)d],差异有统计学意义(P<0.05),而两组患者ICU住院时间差异无统计学意义。死亡组患者RDW、Lac、PCT、APACHEⅡ评分低于生存组,差异有统计学意义(P<0.05)。ROC曲线分析显示,RDW对VAP患者28 d病死率有很高预测价值,其次是Lac和APACHEⅡ评分,PCT无明显预测价值。结论:RDW对VAP患者的预后具有很高的价值,预测价值高于Lac、APACHEⅡ评分及PCT。Objective:To assess the predictive value of red blood cell distribution width(RDW)on the prognosis of patients with ventilator-associated pneumonia(VAP).Methods:The clinical data were reviewed in patients with VAP admitted to the Intensive Care Unit(ICU)of Emergency Department of our hospital between January and December of 2019.The cases were divided into survival group and death group according to 28-day outcome.The general information and laboratory findings at h after admission to the ICU,including the levels of serum lactate(Lac),procalcitonin(PCT)and RDW as well as acute physiology and chronic health evaluationⅡ(APACHEⅡ)scoring,mechanical ventilation time and treatment days in ICU,were recorded.Receiver operating characteristic(ROC)curves were plotted to analyze the prognostic value of Lac,PCT,RDW and APACHEⅡscoring.Results:Results:Seventy-nine cases of VAP were included.Mechanical ventilation time was significantly longer in the death group than in the survival group(P<0.05),yet the days in ICU remained in significant between the two groups.Lower RDW,levels of Lac and PCT as well as APACHEⅡscoring were seen in death group.The difference was significant as compared with the survival group(P<0.05).ROC curve analysis showed that predictive value was the highest by RDW,followed by level Lac and APACHEⅡscoring,for 28-day mortality in patients with VAP,whereas PCT had no predictive value.Conclusion:RDW can be used to estimate the prognosis of patients with VAP,and its predictive value is greater than indicators of Lac,APACHEⅡscoring and PCT.

关 键 词：呼吸机相关肺炎 红细胞分布宽度 乳酸 降钙素原 急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ评分) 

分 类 号：R563.1[医药卫生—呼吸系统]