术后红细胞分布宽度峰值和达峰时间与先天性心脏病患儿术后结局的关系  

Relationship between postoperative peak and peak time of red cell distribution width and postoperative outcomes in childrenwith congenital heart disease

作　　者：卢婷婷 罗润娇 姜磊[1] 黄坚鹄 杨寅愉[1] 王伟[1] Lu Tingting;Luo Runjiao;Jiang Lei;Huang Jianhu;Yang Yinyu;Wang Wei(Institute of Pediatric Translational Medicine,Department of Pediatric Cardiothoracic Surgery,Shanghai Children's Medical Center,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心转化所,心胸外科,上海200127

出　　处：《中国体外循环杂志》2023年第3期136-140,163,共6页Chinese Journal of Extracorporeal Circulation

基　　金：国家自然科学基金(82070430)。

摘　　要：目的探讨先天性心脏病(CHD)儿童接受心脏手术治疗后红细胞分布宽度(RDW)峰值及达峰时间与CHD患儿手术后结局的关系。方法纳入2006年1月1日至2017年12月31日在上海儿童医学中心因先天性心脏病接受心脏手术治疗的12857名患者,收集患者基本信息及实验室检查指标。以logistic回归模型分析术后RDW峰值及达峰时间与术后结局(死亡、急性肾损伤、ICU住院时间>72 h、呼吸机使用时间>72 h、术后住院时间>10 d)的关系。结果术后RDW峰值及达峰时间均与死亡无关;术后RDW达峰时间与呼吸机使用时间>72 h也无关;术后RDW峰值升高和达峰时间缩短是患儿发生急性肾损伤、ICU住院时间>72 h、术后住院时间>10 d的危险因素。结论CHD患儿术后RDW峰值及达峰时间与其术后结局显著相关,可通过检测这两个参数预测患儿预后。Objective To explore the relationship between postoperative red cell distribution width(RDW)peak value,the time to RDW peak value and outcomes of congenital heart disease(CHD)in children.Methods From January 1,2016 to December 31,2017,12857 patients underwent CHD operation in Shanghai Children's Medical Center were included.Demographic characteristics and examination indexes were collected.Logistic regression was used to analyze the relationship between postoperative RDW peak value,time to peak value and postoperative outcomes.Results After adjustment of potential confounders,there was no relationship between postoperative RDW peak value,time to peak value and death,and there was also no relationship between postoperative time to peak value and ventilation use>72 hours.Postoperative RDW peak value was risk factor of AKI,ICU stay>72 hours,ventilation use>72 hours and hospital stay>10 days.Time to postoperative RDW peak value was protective factor for AKI,ICU stay>72 hours and hospital stay>10 days.Conclusions The postoperative peak and peak time of RDW in children with CHD were significantly correlated with their postoperative outcomes,so the prognosis of patients could be predicted by detecting these two parameters.

关 键 词：先天性心脏病 红细胞分布宽度 术后红细胞分布宽度峰值 达峰时间 术后结局 

分 类 号：R726.5[医药卫生—儿科]