红细胞分布宽度与脓毒症患者预后的相关性研究

Correlation study between red blood cell distribution width and the prognosis of patients with sepsis

目的探讨红细胞分布宽度(RDW)与脓毒症患者预后的相关性。方法回顾性分析2013年7月至2015年12月广东省中医院重症监护病房收治的脓毒症患者入院24h内的RDW和急性生理和慢性健康评分Ⅱ(APACHEⅡ评分)。根据患者预后分为存活组和死亡组,采用Mann-Whitney U检验比较两组患者RDW和APACHEⅡ评分的差异;采用Spearman相关分析对RDW和APACHEⅡ评分进行相关性分析;采用受试者工作特征曲线(ROC曲线)评价RDW和APACHEⅡ评分对脓毒症患者出院结局的预测价值。结果死亡组RDW和APACHEⅡ评分均显著高于存活组,差异有统计学意义(P<0.05);Spearman相关分析显示,RDW与APACHEⅡ评分呈显著正相关(r=0.513,P<0.05);RDW和APACHEⅡ评分预测脓毒症患者病死率的ROC曲线下面积分别为0.726和0.696,二者联合的ROC曲线下面积为0.752。结论入院24h内RDW水平对脓毒症患者预后的评估具有重要参考价值。

Objective To investigate the correlation between red blood cell distribution width（RDW）and the prognosis of patients with sepsis.Methods This was a retrospective study.From July 2013 to December 2015,RDW and acute physiology and chronic health evaluationⅡ（APACHE Ⅱ）of septic patients in ICU were enrolled to study.The patients were divided into survival group and death group based on their hospital outcomes.Differences in RDW and APACHE Ⅱ between survival and death groups were analyzed by Mann-Whitney U test.The correlation between RDW and APACHE Ⅱ were analyzed by Spearman correlation test.Receiver operator curve（ROC）test was used to determine the predictive value of RDW and APACHE Ⅱ for hospital death.Results Both RDW and APACHE Ⅱ were significantly higher in death group than in survival group（P〈0.05）.RDW was significantly positively correlated with APACHE Ⅱ（r=0.513,P〈0.05）.Area under the ROC curve of RDW and APACHEⅡ score was 0.726 and 0.696 respectively,the area under the ROC curve of combination was 0.752.Conclusion RDW has important predictive value for the prognosis of patients with sepsis within 24 hafter admission.