[1]张文旭,徐 绸.红细胞宽度对脓毒症患者病情诊断及预后评估的价值[J].医学信息,2022,35(14):71-74.[doi:10.3969/j.issn.1006-1959.2022.14.015]
　ZHANG Wen-xu,XU Chou.The Value of Red-blood-cell Distribution Width in the Diagnosis and Prognosis of Patients with Sepsis[J].Medical Information,2022,35(14):71-74.[doi:10.3969/j.issn.1006-1959.2022.14.015]
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红细胞宽度对脓毒症患者病情诊断及预后评估的价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年14期
页码:
71-74
栏目:
论著
出版日期:
2022-07-15

文章信息/Info

Title:
The Value of Red-blood-cell Distribution Width in the Diagnosis and Prognosis of Patients with Sepsis
文章编号:
1006-1959（2022）14-0071-04
作者:
张文旭; 徐 绸
（解放军联勤保障部队第九八三医院重症医学科，天津 300142）
Author(s):
ZHANG Wen-xu; XU Chou
(Department of Critical Medicine,983 Hospital of the Joint Service Support Force of the People’s Liberation Army,Tianjin 300142,China)
关键词:
脓毒症; 休克; 红细胞宽度; 降钙素原; APACHE Ⅱ评分
Keywords:
Sepsis; Shock; Red-blood-cell distribution width; Procalcitonin; APACHE Ⅱ score
分类号:
R657.1+5
DOI:
10.3969/j.issn.1006-1959.2022.14.015
文献标志码:
A
摘要:
目的 研究红细胞宽度（RDW）预测脓毒症患者预后及疾病进展的价值。方法 回顾性分析2019年9月-2021年8月在我院重症医学科治疗的120例肺部感染疾病导致脓毒症发病患者的临床资料，根据患者脓毒性休克发病情况将其分为休克组（57例）与未休克组（63例），比较休克组与未休克组白细胞计数（WBC）、性别、年龄、30 d病死率、急性生理与慢性健康评分（APACHE Ⅱ评分）、序贯器官衰竭估计量表评分（SOFA评分）、红细胞宽度（RDW）等临床指标；根据30 d内患者是否死亡，将患者分为死亡组（37例）与存活组（83例），比较死亡组与存活组WBC、性别、年龄、APACHE Ⅱ评分、SOFA评分、RDW、疾病程度、降钙素原（PCT）等临床指标；分析影响此类患者预后的独立相关因素、APACHE Ⅱ评分与RDW的相关性、相关因素预测患者预后的价值。结果 休克组30 d病死率、APACHE Ⅱ评分、SOFA评分与RDW高于未休克组，差异有统计学意义（P＜0.05）；死亡组APACHE Ⅱ评分、RDW、年龄、SOFA评分及疾病严重程度高于存活组，差异有统计学意义（P＜0.05）；RDW（OR=1.859，95% CI：1.031~3.357，P=0.040），SOFA评分（OR=2.293，95% CI：1.505~3.496，P＜0.001）、APACHE Ⅱ评分（OR=-0.370，95% CI：2.051~6.641，P＜0.001）、PCT评分（OR=2.132，95% CI：1.151～3.929，P＜0.001）均与脓毒症患者预后相关；RDW预测脓毒症患者预后的价值最高（AUC=0.946，95% CI：0.868~0.979，P＜0.001），敏感度为87.32%，特异度为89.67%，Cut-off值为15.03%。结论 RDW预测脓毒症患者预后价值较高，RDW越高患者病情越严重，预后越差。
Abstract:
Objective To study the value of red-blood-cell distribution width(RDW ) in predicting prognosis and disease progression in patients with sepsis.Methods The clinical data of 120 patients with sepsis caused by pulmonary infection treated in our hospital from September 2019 to August 2021 were retrospectively analyzed. According to the incidence of septic shock, the patients were divided into shock group (57 cases) and non-shock group (63 cases). The white blood cell count (WBC), gender, age, 30-day mortality, acute physiology and chronic health assessment (APACHE Ⅱ score), sequential organ failure estimation scale (SOFA score),red-blood-cell distribution width (RDW) and other clinical indicators of the shock group and the non-shock group were compared. According to whether the patients died within 30 days, the patients were divided into death group (37 cases) and survival group (83 cases). WBC, gender, age, APACHE Ⅱ score, SOFA score, RDW, disease degree, procalcitonin (PCT) and other clinical indicators were compared between the death group and the survival group. The independent related factors affecting the prognosis of such patients, the correlation between APACHE Ⅱ score and RDW, and the value of related factors in predicting the prognosis of patients were analyzed.Results The 30-day mortality, APACHE Ⅱ score, SOFA score and RDW in the shock group were higher than those in the non-shock group, and the differences were statistically significant (P<0.05). APACHE Ⅱ score, RDW, age, SOFA score and disease severity in the death group were higher than those in the survival group, and the difference was statistically significant (P<0.05). RDW (OR=1.859,95%CI:1.031-3.357,P=0.040), SOFA score (OR=2.293,95%CI:1.505-3.496,P<0.001), APACHE Ⅱ score (OR=-0.370,95%CI:2.051-6.641,P<0.001), PCT score (OR=2.132,95%CI:1.151-3.929,P<0.001) were associated with the prognosis of patients with sepsis. RDW had the highest value in predicting the prognosis of sepsis patients (AUC=0.946, 95%CI:0.868-0.979,P<0.001), the sensitivity was 87.32%, the specificity was 89.67%, and the Cut-off value was 15.03%.Conclusion RDW has a high prognostic value in patients with sepsis. The higher the RDW is, the worse the prognosis is.

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更新日期/Last Update: 1900-01-01