红细胞分布宽度对脓毒症患者预后的预测价值  

Prognostic value of red blood cell distribution width on the prognosis of patients with sepsis

作　　者：陈新军[1] 王卿语 加换星 刘丹平[1] CHEN Xinjun;WANG Qingyu;JIA Huanxing;LIU Danping(Emergency Medicine Department,Shaanxi Provincial People's Hospital,Xi'an 710068;Emergency Department,the People's Hospital of Zizhou County,Yulin 718400,China)

机构地区：[1]陕西省人民医院急诊内科,陕西西安710068 [2]子洲县人民医院急诊科,陕西榆林718400

出　　处：《临床医学研究与实践》2022年第21期8-11,共4页Clinical Research and Practice

基　　金：陕西省重点研发计划项目(No.2018SF-225)。

摘　　要：目的研究红细胞分布宽度(RDW)对脓毒症患者预后的预测价值。方法收集2019年3月至8月于陕西省人民医院急诊内科入院24 h内进行观察治疗的脓毒症患者98例,根据预后情况将其分为存活组(53例)以及死亡组(45例)。检测患者入院24 h内在急诊室的血常规、血脂指标水平,并计算急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的最差值。比较两组的临床指标,对急诊室脓毒症患者预后不良的影响因素进行多因素Logistic回归分析,并绘制受试者工作特征(ROC)曲线来分析RDW对脓毒症患者预后的预测价值。结果死亡组的RDW、APACHEⅡ评分均显著高于存活组,差异具有统计学意义(P<0.01)。多因素Logistic回归分析结果显示,RDW是预测急诊室脓毒症患者预后不良的独立危险因素(P=0.02)。ROC曲线显示,RDW预测脓毒症患者预后的灵敏度为75.8%,特异度为78.4%,曲线下面积(AUC)=0.89(95%CI 0.81~0.96)。结论RDW可作为脓毒症患者入急诊室后30 d内死亡的独立预测因子。Objective To study the prognostic value of red blood cell distribution width(RDW)on the prognosis of patients with sepsis.Methods A total of 98 sepsis patients who were observed and treated within 24 h of admission in the emergency department of Shaanxi Provincial People's Hospital from March to August 2019 were collected.According to the prognosis,the patients were divided into survival group(53 cases)and death group(45 cases).The blood routine and blood lipid indexes levels of patients in the emergency room within 24 h after admission were detected,and the worst value of the acute physiology and chronic health evaluationⅡ(APACHEⅡ)score was calculated.The clinical indexes of the two groups were compared,the influencing factors of poor prognosis of patients with sepsis in the emergency room were analyzed by multivariate Logistic regression,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of RDW on the prognosis of patients with sepsis.Results The RDW and APACHEⅡscore in the death group were significantly higher than those in the survival group(P<0.01).Multivariate Logistic regression analysis result showed that RDW was an independent risk factor for predicting poor prognosis of patients with sepsis in emergency room(P=0.02).ROC curve showed that the sensitivity of RDW in predicting the prognosis of sepsis patients was 75.8%,the specificity was 78.4%,and area under the curve(AUC)was 0.89(95%CI 0.81-0.96).Conclusion RDW can be used as an independent predictor of death within 30 d after sepsis patients entering the emergency room.

关 键 词：脓毒症 急诊室 红细胞分布宽度 

分 类 号：R631.2[医药卫生—外科学]