青海省先天性心脏病患儿RDW与肺炎危重程度的相关性研究  

Correlation between RDW and pneumonia criticality in children with congenital heart disease in Qinghai Province

作　　者：曲雪 赵生奎 王美英 王昆 戚继荣[4] QU Xue;ZHAO Shengkui;WANG Meiying;WANG Kun;QI Jirong(Graduate School of Qinghai University,Qinghai Xining 810000,China;Qinghai Province Women and Children's Hospital,Qinghai Xining 810000 China;Red Cross Society of Qinghai,Qinghai Xining 810000,China;Children's Hospital of Nanjing Medical University,Jiangsu Nanjing 210008,China)

机构地区：[1]青海大学研究生院,青海西宁810000 [2]青海省妇女儿童医院,青海西宁810000 [3]青海省红十字会,青海西宁810000 [4]南京医科大学附属儿童医院,江苏南京210008

出　　处：《中国妇幼健康研究》2023年第10期14-19,共6页Chinese Journal of Woman and Child Health Research

基　　金：青海省卫健委重点课题(2021-wjzd-04)。

摘　　要：目的探讨青海省儿童先天性心脏病(CHD)患者中红细胞分布宽度(RDW)与肺炎危重程度的相关性,以及评估RDW对病情危重程度的预测价值。方法回顾性分析2021年1月至2022年8月在青海省妇女儿童医院接受治疗的79例CHD合并肺炎患儿的临床资料,根据诊断结果将CHD合并肺炎患儿分为观察组(CHD合并重症肺炎)及对照组(CHD合并非重症肺炎);依据RDW变异系数(RDW-CV)分为RDW-CV正常组和RDW-CV升高组。分析各组间RDW-CV、白细胞计数(WBC)、降钙素原(PCT)、C反应蛋白(CRP)、小儿危重病例评分(PCIS)、住院时间、死亡人数的差异;绘制受试者工作特征曲线(ROC),推测RDW对病情危重程度的判断价值。结果观察组的RDW-CV(t=3.725)、PCT(z=2.203)、CRP(z=2.812)、PCIS评分(t=3.669)、死亡人数(包括放弃治疗)(χ^(2)=6.067)较对照组明显增高,差异均有统计学意义(P<0.05);WBC、住院时间两组差异均无统计学意义(P>0.05)。RDW-CV升高组的RDW-CV(t=11.002)、WBC(z=2.216)、PCT(z=2.232)及常居地海拔(t=4.732)明显高于RDW-CV正常组,差异均有统计学意义(P<0.05);PCIS评分、住院时间及死亡人数(包括放弃治疗)两组差异均无统计学意义(P>0.05)。RDW预测病情危重的曲线下面积(AUC)为0.646(95%CI:0.523~0.769),当截断值为16.15%时,敏感度为53.60%,特异度为87.00%。结论RDW与CHD合并肺炎儿童的病情危重程度、常居地海拔高度密切相关,对于病情危重程度的判断有较好的临床价值。Objective To investigate the correlation between red blood cell distribution width(RDW)and the pneumonia critical degree in children with congenital heart disease(CHD)patients in Qinghai Province,and to assess the predictive value of RDW on the criticality of disease.Methods The clinical data of 79 children with CHD combined with pneumonia treated at Qinghai Woman and Children's Hospital from January 2021 to August 2022 were retrospectively analyzed.According to the diagnostic results,the children with CHD combined with pneumonia were divided into the observation group(CHD combined with severe pneumonia)and the control group(CHD combined with non-severe pneumonia).According to the coefficient of variation of RDW(RDW-CV),they were divided into normal RDW-CV group and elevated RDW-CV group.The differences of RDW-CV,white blood cell(WBC)count,procalcitonin(PCT),C-reactive protein(CRP),paediatric critical illness score(PCIS),duration of hospital stay,and number of deaths were analyzed among the groups.Receiver operating characteristic curve(ROC)was plotted to estimate the value of RDW in determining the criticality of disease.Results In the observation group,RDW-CV(t=3.725),PCT(z=2.203),CRP(z=2.812),PCIS score(t=3.669),and the number of deaths(including the abandonment of treatment)(χ^(2)=6.067)were significantly higher than those in the control group,with statistically significant differences(all P<0.05),while the differences in terms of WBC and duration of hospital stay were not statistically significant(P>0.05).In the RDW-CV elevated group,RDW-CV(t=11.002),WBC(z=2.216),PCT(z=2.232)and altitude of usual residence(t=4.732)were significantly higher than those in the RDW-CV normal group,with statistically significant differences(all P<0.05),while the differences in terms of PCIS scores,duration of hospital stay,and number of deaths(including abandonment of treatment)were not statistically significant(P>0.05).The area under the curve(AUC)of RDW for predicting critical illness was 0.646(95%CI:0.523-0.769),and when the

关 键 词：红细胞分布宽度 青海省 儿童 先天性心脏病合并肺炎 危重程度 

分 类 号：R174[医药卫生—妇幼卫生保健]