红细胞宽度对脓毒症患者病情程度及预后评估的作用

Role of red blood cell distribution width in assessing severity and prognosis of patients with sepsis

目的探讨红细胞宽度（RDW）在判断脓毒症患者病情严重程度及预后中的作用。方法收集129例脓毒症患者的基本资料，根据病情严重程度将其分为非严重脓毒症组与严重脓毒症组（包括脓毒症休克）；根据患者28天预后将患者分为死亡组与存活组；根据RDW是否升高将患者分为RDW正常组（≤16％）和RDW升高组（〉16％）；绘制Kaplan-Meier生存曲线，比较不同RDW组患者的预后。结果严重脓毒症组患者RDW升高率为89．4％，非严重脓毒症组患者RDW升高率为14．3％％，两组比较差异有统计学意义（P〈0．05）；死亡组患者RDW升高率为78．4％，存活组患者RDW升高率为42．4％，两组比较差异有统计学意义（P〈0．05）；RDW升高组患者的严重脓毒症比例为86．8％，28天病死率为42．6％，RDW正常组患者的严重脓毒症比例为11．5％，28天病死率为13．1％，两项指标比较有统计学意义（P〈0．05）；Kaplan-Meier生存分析结果显示，RDW升高组患者的中位生存时间为23天，RDW正常组患者的中位生存时间为26天，两组比较差异有统计学意义（P〈0．01）。结论RDW与脓毒症患者的病情严重程度以及预后有关，可作为判断病情严重程度以及预后评估的指标之一。

Objective To investigate the affection of RDW in judging the severity and prognosis of sepsis patients. Methods Basic clinical data of 129 cases of patients with sepsis was collected. Patients were divided into non-severe sepsis group and severe sepsis group（ including septic shock） ac- cording to the severity of the disease, divided into non-survival group and survival group according to the prognosis of the patients at 28th day and divided into RDW normal group（ RDW elevated ≤ 16% ） and ele- vated RDW group（ RDW elevated 〉 16% ）. Kaplan-Meier survival curves were drawn and the prognosis of patients with different RDW groups was compared. Results Result RDW increased ration of severe group was 89.4% and RDW increased ration of non-severe group was 14.3%. The difference between the two groups was statistically significant （ P 〈 0. 05 ）. RDW increased ration of non - survival group was 78.4% and RDW increased ration of survival group was 42.4%, The difference between the two groups was statistically significant（ P 〈 0.05 ）. The severe sepsis ration of RDW elevated group was 86.8% and 28 d mortality rate was 42.6%. The severe sepsis ration of RDW nomal group was 11.5% and 28 d mor- tality rate was 13. 1%. The difference between the two groups was statistically significant （P 〈 0.05）. Kaplan-Meier survival analysis showed the median survival time of the RDW normal group was significant- ly higher than the RDW elevated group（ P 〈 0.01 ）. Conclusion RDW has a positive relationship with the degree of illness and prognosis in patients with sepsis, and it can be used as an indicator to determine the severity and prognosis of sepsis.