[1]王 源,辛彩霞,杨海英,等.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[J].医学信息,2025,38(07):67-71.[doi:10.3969/j.issn.1006-1959.2025.07.011]
　WANG Yuan,XIN Caixia,YANG Haiying,et al.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[J].Journal of Medical Information,2025,38(07):67-71.[doi:10.3969/j.issn.1006-1959.2025.07.011]
点击复制

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()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
38卷
期数:
2025年07期
页码:
67-71
栏目:
论著
出版日期:
2025-04-01

文章信息/Info

Title:
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
文章编号:
1006-1959（2025）07-0067-05
作者:
王 源1; 辛彩霞1; 杨海英1; 陈 丹2; 黄 娜3
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
Author(s):
WANG Yuan1;  XIN Caixia1;  YANG Haiying1;  CHEN Dan2;  HUANG Na3
1.Department of Respiratory and Critical Care Medicine, Renshou County People’s Hospital, Renshou 620500, Sichuan, China;2.Respiratory Department of Yunchang Hospital in Renshou County, Renshou 620500, Sichuan, China;3.Department of Respiratory and Crit
关键词:
MIMIC-IV数据库; 红细胞分布宽度; AECOPD; 预后
Keywords:
MIMIC-IV database;  Red blood cell distribution width;  AECOPD;  Prognosis
分类号:
R563
DOI:
10.3969/j.issn.1006-1959.2025.07.011
文献标志码:
A
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%）（χ2=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。
Abstract:
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%) (χ2=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.

参考文献/References:

[1]Baqdunes MW,Leap J,Young M,et al.Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J].Crit Care Nurs Q,2021,44(1):74-90.[2]Safier Frenkel T,Evans DD.Are Antibiotics Useful in Acute Chronic Obstructive Pulmonary Disease Exacerbations?Implications for APRN Practice[J].Adv Emerg Nurs J,2020,42(3):164-169.[3]Maniu I,Costea R,Maniu G,et al.Inflammatory Biomarkers in Febrile Seizure:A Comprehensive Bibliometric,Review and Visualization Analysis[J].Brain Sci,2021,11(8):1077.[4]Joosse HJ,van Oirschot BA,Kooijmans SAA,et al.In-vitro and in-silico evidence for oxidative stress as drivers for RDW[J].Sci Rep,2023,13(1):9223.[5]Deniz M,Ozgun P,Ozdemir E.Relationships between RDW,NLR,CAR,and APACHE II scores in the context of predicting the prognosis and mortality in ICU patients[J].Eur Rev Med Pharmacol Sci,2022,26(12):4258-4267.[6]Ye W,Li R,Liang H,et al.Development and validation of a clinical risk model to predict the hospital mortality in ventilated patients with acute respiratory distress syndrome:a population-based study[J].BMC Pulm Med,2022,22(1):268.[7]Zhang L,Huang T,Xu F,et al.Prediction of prognosis in elderly patients with sepsis based on machine learning(random survival forest)[J].BMC Emerg Med,2022,22(1):26.[8]Zhuo MF,Zhang KL,Shen XB,et al.Postoperative adverse cardiac events in acute myocardial infarction with high thrombus load and best time for stent implantation[J].World J Clin Cases,2022,10(7):2106-2114.[9]Buha I,Miric M,Agic A,et al.A randomized,double-blind,placebo-controlled study evaluating the efficacy of propolis and N-acetylcysteine in exacerbations of chronic obstructive pulmonary disease[J].Eur Rev Med Pharmacol Sci,2022,26(13):4809-4815.[10]Qiu Y,Wang Y,Shen N,et al.Association Between Red Blood Cell Distribution Width-Albumin Ratio and Hospital Mortality in Chronic Obstructive Pulmonary Disease Patients Admitted to the Intensive Care Unit:A Retrospective Study[J].Int J Chron Obstruct Pulmon Dis,2022,8(17):1797-1809.[11]Ng WW,Lam SM,Yan WW,et al.NLR,MLR,PLR and RDW to predict outcome and differentiate between viral and bacterial pneumonia in the intensive care unit[J].Sci Rep,2022,12(1):15974.[12]沈鹏远,周庆,钟磊.红细胞分布宽度对重症急性呼吸衰竭患者近期死亡的影响[J].现代实用医学,2023,35(3):323-325,421.[13]边娟,李水霞,白雪瑞,等.红细胞分布宽度水平在预测慢性阻塞性肺疾病急性加重的应用价值研究[J].中国医药科学,2022,12(12):147-150.[14]Melchio R,Giamello JD,Testa E,et al.RDW-based clinical score to predict long-term survival in community-acquired pneumonia:a European derivation and validation study[J].Intern Emerg Med,2021,16(6):1547-1557.[15]Soni M,Gopalakrishnan R.Significance of RDW in predicting mortality in COVID-19-An analysis of 622 cases[J].Int J Lab Hematol,2021,43(4):221-223.[16]Bommenahalli Gowda S,Gosavi S,Ananda Rao A,et al.Prognosis of COVID-19:Red Cell Distribution Width,Platelet Distribution Width,and C-Reactive Protein[J].Cureus,2021,13(2):e13078.[17]Saad E,Maamoun B,Nimer A.Increased Red Blood Cell Distribution Predicts Severity of Chronic Obstructive Pulmonary Disease Exacerbation[J].J Pers Med,2023,13(5):843.[18]Kashiwada T,Tanaka Y,Tanaka T,et al.Clinical course of COPD patients with exercise-induced elevation of pulmonary artery pressure or less severe pulmonary hypertension presenting with respiratory symptoms and the impact of bosentan intervention-prospective,single-center,randomized,parallel-group study[J].BMC Pulmonary Medicine,2024,24(1):90.[19]Gayen KS,Zulty M,Criner JG.Elevated pulmonary vascular resistance is associated with increased lung transplant waitlist mortality among patients with chronic obstructive pulmonary disease and pulmonary hypertension:a retrospective cohort analysis[J].Respiratory Research,2024,25(1):79.[20]Groenewegen A,Zwartkruis WV,Rienstra M,et al.Diagnostic yield of a proactive strategy for early detection of cardiovascular disease versus usual care in adults with type 2 diabetes or chronic obstructive pulmonary disease in primary care in the Netherlands(RED-CVD):a multicentre,pragmatic,cluster-randomised,controlled trial[J].Lancet Public Health,2024,9(2):e88-e99.[21]Bekelman BD,Feser W,Morgan B,et al.Nurse and Social Worker Palliative Telecare Team and Quality of Life in Patients With COPD,Heart Failure,or Interstitial Lung Disease:The ADAPT Randomized Clinical Trial[J].JAMA,2024,331(3):212-223.[22]Na LY,Min C,Hui W,et al.Construction and validation of nomogram prediction model for risk of acute heart failure in patients with acute exacerbation of chronic obstructive pulmonary disease[J].Medicine,2024,103(1):e36840.[23]Fang H,Ping Z,Yan C,et al.Red blood cell distribution width and serum CA-125 level as prognostic markers in acute exacerbation of chronic obstructive pulmonary disease[J].Journal of International Medical Research,2021,49(5):03000605211020229.

相似文献/References:

[1]王 坤,张永春.血清胆红素水平、单核细胞数、红细胞分布宽度与 冠状动脉病变程度的关系[J].医学信息,2018,31(08):53.[doi:10.3969/j.issn.1006-1959.2018.08.017]
　WANG Kun,ZHANG Yong-chun.Relationship between Serum Bilirubin Level,Monocyte Count,Red Blood Cell Distribution Width and Severity of Coronary Artery Disease[J].Journal of Medical Information,2018,31(07):53.[doi:10.3969/j.issn.1006-1959.2018.08.017]
[2]车鹏博,阮继刚,郭 丹.红细胞分布宽度联合D-二聚体含量预测 急性胰腺炎严重程度的价值[J].医学信息,2018,31(12):73.[doi:10.3969/j.issn.1006-1959.2018.12.022]
　CHE Peng-bo,RUAN Ji-gang,GUO Dan.The Value of Red Blood Cell Distribution Width Combined with D-dimer Content in Predicting the Severity of Acute Pancreatitis[J].Journal of Medical Information,2018,31(07):73.[doi:10.3969/j.issn.1006-1959.2018.12.022]
[3]刘 浩.冠心病冠脉病变严重程度与红细胞分布宽度及尿酸的相关性分析[J].医学信息,2018,31(19):93.[doi:10.3969/j.issn.1006-1959.2018.19.027]
　LIU Hao.Correlation Analysis of Severity of Coronary Artery Disease with Erythrocyte Distribution Width and Uric Acid in Patients with Coronary Heart Disease[J].Journal of Medical Information,2018,31(07):93.[doi:10.3969/j.issn.1006-1959.2018.19.027]
[4]臧传丽,朴红梅.RDW、PLR、NLR及RCI在COPD中的临床意义[J].医学信息,2022,35(15):153.[doi:10.3969/j.issn.1006-1959.2022.15.036]
　ZANG Chuan-li,PIAO Hong-mei.Clinical Significance of RDW, PLR, NLR and RCI in Chronic Obstructive Pulmonary Disease[J].Journal of Medical Information,2022,35(07):153.[doi:10.3969/j.issn.1006-1959.2022.15.036]
[5]尚 波,金 菁.红细胞分布宽度在卒中后抑郁患者血清中的变化 及与炎症因子的关系[J].医学信息,2019,32(16):80.[doi:10.3969/j.issn.1006-1959.2019.16.024]
　SHANG Bo,JIN Jing.Changes of Erythrocyte Distribution Width in Serum of Patients with Post-stroke Depression and Its Relationship with Inflammatory Factors[J].Journal of Medical Information,2019,32(07):80.[doi:10.3969/j.issn.1006-1959.2019.16.024]
[6]李淅萌,聂英坤.新型炎症因子在结缔组织病中的研究[J].医学信息,2019,32(22):24.[doi:10.3969/j.issn.1006-1959.2019.22.09]
　LI Xi-meng,NIE Ying-kun.Study on Novel Inflammatory Factors in Connective Tissue Diseases[J].Journal of Medical Information,2019,32(07):24.[doi:10.3969/j.issn.1006-1959.2019.22.09]
[7]张 余,曹灵红,徐 平,等.急性心衰患者红细胞分布宽度变异系数与肺超声积分的相关性[J].医学信息,2020,33(01):104.[doi:10.3969/j.issn.1006-1959.2020.01.031]
　ZHANG Yu,CAO Ling-hong,XU Ping,et al.Correlation Between Variation Coefficient of Red Blood Cell Distribution Width and Pulmonary Ultrasound Score in Patients with Acute Heart Failure[J].Journal of Medical Information,2020,33(07):104.[doi:10.3969/j.issn.1006-1959.2020.01.031]
[8]徐丽青.RDW与重症急性胰腺炎病情及预后的相关性[J].医学信息,2020,33(16):115.[doi:10.3969/j.issn.1006-1959.2020.16.035]
　XU Li-qing.Correlation of RDW with Severity and Prognosis of Severe Acute Pancreatitis[J].Journal of Medical Information,2020,33(07):115.[doi:10.3969/j.issn.1006-1959.2020.16.035]
[9]肖改荣,丁新苑,云宗金.急性脑梗死不良预后的危险因素分析及RDW与MPV的预测[J].医学信息,2020,33(24):67.[doi:10.3969/j.issn.1006-1959.2020.24.019]
　XIAO Gai-rong,DING Xin-yuan,YUN Zong-jin.Analysis of Risk Factors for Poor Prognosis of Acute Cerebral Infarction and Prediction of RDW and MPV[J].Journal of Medical Information,2020,33(07):67.[doi:10.3969/j.issn.1006-1959.2020.24.019]
[10]胡见英.血浆BNP、PDW与RDW联合测定诊断慢性心力衰竭的价值[J].医学信息,2021,34(02):174.[doi:10.3969/j.issn.1006-1959.2021.02.049]
　HU Jian-ying.The Value of Combined Determination of Plasma BNP,PDW and RDW in the Diagnosis of Chronic Heart Failure[J].Journal of Medical Information,2021,34(07):174.[doi:10.3969/j.issn.1006-1959.2021.02.049]

更新日期/Last Update: 1900-01-01