老年患者红细胞分布宽度异常相关因素及对预后的影响

Related factors of abnormal RDW and the influence between RDW and the prognosis of elderly patients

目的 本研究对老年患者红细胞分布宽度(RDW)升高的原因进行探讨,同时对RDW升高与预后相关性进行随访。方法 收集本院老年科2009年5月至2012年3月住院的老年患者共498例(年龄≥60岁),根据入院24h首次RDW检测结果,分为RDW升高组及正常组。分别对患者的基本资料、诊断、红细胞参数、炎症指标等进行统计分析,并随访所有患者1年内再次入院次数及病死率。结果 发现老年患者RDW升高(P<0.01),而RDW升高患者其体质量指数(BMI)较低(P<0.05)。与RDW正常组比较,RDW升高组的患者中合并感染及慢性阻塞性肺疾病(COPD)比例较高,其血红蛋白(Hb)显著降低,C反应蛋白(CRP)水平升高(P<0.01),住院时间较长(P<0.05)。所有患者随访时间1年,结果发现RDW升高组患者1年内再住院率及病死率较高。结论 通过检测RDW,对老年合并慢性疾病的患者进行初步评估,简单易行。动态观察RDW可以对疾病的严重程度进行评估,并可以评价干预措施的治疗效果。

Objective To investigate the reason of elderly patients with increasing red blood cell distribution width(RDW),at the same time to develop the follow-up study of the correlation between the increased RDW and the prognosis of elderly patients.Methods The data of 498 patients who were more than 60 years old hospitalized in Department of Geriatrics from May 2009 to March 2012 were collected.According to the detection results of RDW the first time in 24 h after the admission,these patients were divided into higher RDW group and normal RDW group.The patients' basic information,diagnosis,red blood cell parameters,indicators of inflammation were analyzed respectively and rehospitalization rate and mortality of all patients were followed up within 1 year.Results RDW of elderly patients was increased(P<0.01),while body mass index(BMI) in patients with increased RDW was lower.The patients with increased RDW had a higher incidence rate of infection and chronic obstructive pulmonary disease(COPD).Hemoglobin in patients with increased RDW was lower than that in patients with normal RDW;but the level of C reactive protein was higher than that of normal RDW group.The hospitalization time of higher RDW group was longer than that of the control group(P<0.05).All patients were followed up for 1 year,the results showed that the rehospitalization rate and mortality of higher RDW group was higher than that of normal RDW group.Conclusions We could assess the severity of chronic disease and evaluate the treatment effects via monitoring RDW dynamicly.