慢性阻塞性肺疾病急性加重患者在院期间红细胞分布宽度与预后相关性研究  

A Study on the Correlation Between Red Blood Cell Distribution Width and Prognosis in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease During Hospitalization

作　　者：王源 辛彩霞[1] 杨海英[1] 陈丹 黄娜[3] WANG Yuan;XIN Caixia;YANG Haiying;CHEN Dan;HUANG Na(Department of Respiratory and Critical Care Medicine,Renshou County People's Hospital,Renshou 620500,Sichuan,China;Respiratory Department of Yunchang Hospital in Renshou County,Renshou 620500,Sichuan,China;Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,Sichuan,China)

机构地区：[1]仁寿县人民医院呼吸与危重症医学科,四川仁寿620500 [2]仁寿县运长医院呼吸内科,四川仁寿620500 [3]成都医学院第一附属医院呼吸与危重症医学科,四川成都610500

出　　处：《医学信息》2025年第7期67-71,共5页Journal of Medical Information

基　　金：国家临床重点专科建设培育科室专项科研项目(编号:CYFY2018GLPHX02);四川省医学科研创新课题(编号:Q18041)。

摘　　要：目的探究慢性阻塞性肺疾病急性加重(AECOPD)患者在院期间红细胞分布宽度(RDW)水平与AECOPD患者预后的相关性。方法从MIMIC-IV公共数据库提取2008年1月-2019年12月入住重症监护病房的AECOPD患者的临床资料。根据红细胞分布宽度水平分为高RDW组(RDW>15%)和正常RDW组(RDW≤15%),比较两组AECOPD患者一般情况。使用Kaplan-Meier法绘制生存曲线,比较两组1年生存率差异。ROC曲线评估RDW对AECOPD患者1年内死亡的诊断价值。采用Cox比例风险回归分析影响AECOPD患者死亡的危险因素。结果共纳入608例AECOPD患者。与正常RDW组相比,高RDW组患者合并高血压、糖尿病、心衰比例、SOFA评分高于RDW正常组(P<0.05)。高RDW组患者1年死亡率(80.57%)高于正常RDW组(71.09%)(χ^(2)=7.121,P=0.007)。ROC曲线结果表明,RDW预测AECOPD患者1年内死亡的曲线下面积为0.68(95%CI:0.54,0.82)。灵敏度为0.79,特异度为0.72,最佳截断值为15.8%。Cox比例风险回归分析结果提示RDW是预测AECOPD患者死亡的独立危险因素(HR=1.272,95%CI:1.062,1.543,P=0.013)。结论RDW值升高是影响AECOPD患者预后的独立危险因素,可用于判断AECOPD患者死亡风险。Objective To explore the correlation between red blood cell distribution width(RDW)and the prognosis of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients during hospitalization.Methods The clinical data of AECOPD patients admitted to the intensive care unit from January 2008 to December 2019 were extracted from the MIMIC-IV public database.According to the level of red blood cell distribution width,they were divided into high RDW group(RDW>15%)and normal RDW group(RDW≤15%).The general conditions of AECOPD patients in the two groups were compared.Kaplan-Meier method was used to draw the survival curve to compare the difference of 1-year survival rate between the two groups.ROC curve was used to evaluate the diagnostic value of RDW in the death of AECOPD patients within 1 year.Cox proportional hazard regression analysis was used to analyze the risk factors affecting the death of AECOPD patients.Results A total of 608 AECOPD patients were included.Compared with the normal RDW group,the proportion of hypertension,diabetes,heart failure and SOFA score in the high RDW group were higher than those in the normal RDW group(P<0.05).The 1-year mortality of patients in the high RDW group(80.57%)was higher than that in the normal RDW group(71.09%)(χ^(2)=7.121,P=0.007).The results of ROC curve showed that the area under the curve of RDW predicting the death of AECOPD patients within 1 year was 0.68(95%CI:0.54,0.82),the sensitivity was 0.79,the specificity was 0.72,and the best cut-off value was 15.8%.The results of Cox proportional hazard regression analysis showed that RDW was an independent risk factor for predicting the death of AECOPD patients(HR=1.272,95%CI:1.062,1.543,P=0.013).Conclusion The increase of RDW value is an independent risk factor affecting the prognosis of patients with AECOPD,which can be used to judge the risk of death in patients with AECOPD.

关 键 词：MIMIC-IV数据库 红细胞分布宽度 AECOPD 预后 

分 类 号：R563[医药卫生—呼吸系统]