红细胞体积分布宽度对脓毒症急性肾损伤患者预后的评估价值

Value of red blood cell distribution width in prognosis of acute kidney injury associated with sepsis

目的探讨红细胞体积分布宽度(RDW)与脓毒症急性肾损伤(AKI)患者预后的关系。方法选取2011年3月至2013年12月入住我院ICU确诊为脓毒症AKI患者89例,按其预后分为死亡组和存活组,分别测定动脉血乳酸(Lac)、血肌酐(Scr)、血小板(PLT)及RDW水平,同时进行急性生理学及慢性健康评估(APACHEⅡ)评分。选取20例健康体检者作为对照组。结果存活组RDW水平显著低于死亡组,差异具有统计学意义(存活组vs死亡组,t=5.16,P<0.01);存活组动脉血乳酸水平显著低于死亡组(存活组vs死亡组,t=12.88,P<0.01);存活组PLT水平高于死亡组(存活组vs死亡组,t=1.99,P<0.05);存活组APACHEⅡ评分低于死亡组(存活组vs死亡组,t=4.00,P<0.05)。结论 RDW可预测ICU中脓毒症AKI患者的预后。

Objective To investigate the relationship between red blood cell distribution width （RDW） and the prognosis of acute kidney injury （AKI） associated with sepsis. Methods Eighty-nine patients diagnosed as AKI associated with sepsis in ICU of our hospital during March 2011 to December 2013 were selected and divided into sur- vival group （n=55） and death group （n=34）. The levels of arterial blood lactate （Lac）, serum creatinine （sCr）, red blood cell distribution width （RDW） and blood platelet （PLT） were measured. Moreover, the acute physiology and chronic health evaluation scoring （APACHE II ） were collected. Meanwhile, twenty healthy volunteers were enrolled as the control group （n=20）. Results Compared with the survival group, the expression levels of Lac, RDW and APACHE H significantly increased （Lac, t=12.88, P〈0.01; RDW t=5.16, P〈0.01; APACHE II t=4.00, P〈0.05）. However, PLT significantly decreased in death group （survival group vs death group, t=1.99, P〈0.05）. Conclusion RDW is a reli- able indicator to predict the prognosis of AKI associated with sepsis.