| 红细胞分布宽度对肺炎并感染性休克病人预后的预测价值 |
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| 引用本文： | 王喆,李华,张劲松.红细胞分布宽度对肺炎并感染性休克病人预后的预测价值[J].蚌埠医学院学报,2018,43(11):1437-1439. |
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| 作者姓名： | 王喆 李华 张劲松 |
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| 作者单位： | 南京医科大学第一附属医院 急诊中心, 江苏 南京 210029 |
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| 摘 要： | 目的:探讨肺炎并感染性休克病人红细胞分布宽度（RDW）与急性生理学与慢性健康状况评分Ⅱ（APACHE Ⅱ）、序贯器官衰竭估计（SOFA）评分及预后的关系。方法:采用病例对照研究，回顾分析86例肺炎并感染性休克病人，根据28 d预后分为存活组（n=50）和死亡组（n=36）。入院当天检测RDW、白细胞计数（WBC）、血红蛋白（Hb）、血小板计数（PLT）、红细胞压积（HCT）及血小板分布宽度（PDW），并进行APACHE Ⅱ及SOFA评分。评价RDW及其他指标与病情严重程度及预后的关系。结果:死亡组RDW显著高于存活组（P<0.01），Hb、HCT显著低于存活组（P<0.05），死亡组与存活组在WBC、PLT、PDW上差异无统计学意义（P>0.05）。死亡组APACHE Ⅱ及SOFA评分均显著高于存活组（P<0.05）。logistic回归分析显示，SOFA评分（OR=1.282，95%CI:1.012～1.625，P<0.05）和RDW（OR=2.986，95%CI:1.661～5.368，P<0.01）为肺炎并感染性休克病人死亡独立危险因素。RDW预测肺炎并感染性休克病人死亡风险的最佳截断阈值为15.05%（95%CI:0.767～0.948，P<0.01）。结论:RDW可作为预测肺炎并感染性休克病人预后的临床指标。RDW监测简单易行、费用低廉，可作为其他评估指标的有效补充。
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| 关 键 词： | 红细胞分布宽度 肺炎 感染性休克 预后 |
| 收稿时间： | 2018-07-08 |
The predictive value of red cell distribution width on the prognosis of pneumonia patients complicated with septic shock |
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| Affiliation: | Emergency Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing Jiangsu 210029, China |
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| Abstract: | Objective: To explore the association of red cell distribution width(RDM) with acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score,sequential organ failure assessment(SOFA) score,and prognosis of pneumonia patients complicated with septic shock.Methods: According to the case-control study,the clinical data in 86 pneumonia patients complicated with septic shock were retrospectively analyzed,and divided into the survival group(n=50) and death group(n=36) according to the 28-day prognosis.The RDW,white blood cell(WBC) count,hemoglobin(Hb),platelet(PLT) count,hematokrit(HCT) and platelet distribution width(PDW) were detected on admission,and the APACHE Ⅱ score and SOFA score in two groups were assessed.The relationship between RDW and other indexes,and disease severity and prognosis were evaluated.Results: The RDW in death group was significantly higher than that in survival group(P<0.01),the levels of Hb and HCT in death group were significantly lower than those in survival group(P<0.01),the differences of WBC,PLT and PDW between two groups were not statistical significance(P>0.05),and the scores of APACHE Ⅱ and SOFA in death group were significantly higher than those in survival group(P<0.01).Logistic regression analysis showed that the SOFA score(OR=1.282,95%CI 1.012-1.625,P<0.05) and RDW(OR=2.986,95%CI 1.661-5.368,P<0.01) were the independent risk factors of the death in pneumonia patients complicated with septic shock.The best cut-off value of RDW predicting the death risk of pneumonia patients complicated with septic shock was 15.05%(95%CI 0.767-0.948,P<0.01).Conclusions: RDW can be a clinical index in predicting the prognosis of pneumonia patients complicated with septic shock.The RDM examination is simple and low cost,which can be act as a complementary index. |
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