红细胞分布宽度变异系数对脓毒症患者预后的评估价值

Evaluation value of red cell distribution width coefficient of variation(RDW-CV) for the prognosis in patients with sepsis

目的 探讨红细胞分布宽度变异系数（RDW-CV）对脓毒症患者预后的评估价值。方法 回顾性分析2014年10月～2016年6月收治的脓毒症RDW-CV升高者120例,根据入院时RDW-CV分为〈13.5%组,13.5%～15.5%组及〉15.5%组,计算相应组APACHE-Ⅱ评分平均值,相应组死亡率,判断RDW-CV与APACHE-Ⅱ评分的相关性,采用多因素Logistic回归分析死亡相关因素,比较各组预测能力及入院第1天及第5天RDW-CV动态变化分为升高组及下降组,判断RDW-CV动态变化对死亡率的影响。结果 RDW-CV值越高其APACHE-Ⅱ评分越高,患者临床死亡率越高,RDW-CV升高且APACHE-Ⅱ评分〉15分为预测患者28 d内死亡的独立危险因素,第1天及第5天RDW-CV值升高组的临床死亡率显著高于下降组（P〈0.05）。结论 RDW-CV值升高程度及动态变化趋势能有效预测脓毒症患者的预后,判断其死亡率,尤其是RDW-CV升高且APACHE-Ⅱ评分〉15分者,其28 d内死亡率显著增高。

Objective To investigate the value of red cell distribution width coefficient of variation（RDW-CV） for the prognosis in patients with sepsis.Methods 120 patients with sepsis and with elevated RDW-CV treated from October2014 to June 2016 were retrospectively analyzed and patients were divided into DW-CV〈13.5% group,13.5%-15.5%group and 〉15.5% group according to the admission time,then mean value of APACHE-Ⅱ score and mortality in the corresponding mortality was calculated respectively.The correlation of RDW-CV and APACHE-Ⅱ score was judged,and the related factors of death was analyzed using multivariate Logistic regression analysis,and prediction ability of each group was compared.Patients were increased group and decreased group according to dynamic change of RDWCV in the first and fifth days on admission to judge the impact factor of the dynamic change of RDW-CV on mortality.Results RDW-CV value and APACHE-Ⅱ score were higher,they had higher clinical mortality in patients,RDW rising and APACHE-Ⅱ score〉15 points was an independent risk factor to predict the mortality within 28 days,and the clinical mortality in increased RDW-CV group in the first and fifth days on admission was significantly higher than that of the decreased group（P〈0.05）.Conclusion RDW-CV value increasing degree and dynamic change trend can effectively predict the prognosis of patients with sepsis to judge the mortality rate,and especially for patients with elevated RDWCV and APACHE-Ⅱ score 〉15 points,the mortality within 28 days for them is obviously increased.