RDW预测急性胰腺炎死亡风险的价值及其与网织红细胞各参数相关性的研究

Value of RDW for predicting death risk in acute pancreatitis and its correlation with Ret parameters

目的探讨红细胞分布宽度(RDW)预测急性胰腺炎(AP)患者死亡风险的价值及其与网织红细胞(Ret)各参数的相关性。方法选取中南大学湘雅二医院急诊外科2015年3月至2016年5月收治的AP患者164例,其中生存患者151例,死亡患者13例,另选取175例体检健康者作为对照组;抽取研究对象静脉血,采用Sysmex XN-1000全自动血液分析仪检测全血RDW和Ret各参数。组间比较行Mann-Whitney U、Kruskal-Wallis H检验;用受试者工作特征曲线(ROC)和曲线下面积(AUC)评价RDW对AP死亡风险的诊断价值;RDW与健康者、AP患者Ret各参数的相关性行Spearman相关检验。结果 AP死亡组RDW水平为[15.7%(14.1%~21.8%)]高于AP生存组的[13.3%(12.7%~14.5%)],差异有统计学意义(Z=40.02,P<0.05);以RDW水平诊断AP死亡风险的ROC曲线AUC为0.835(95%CI:0.786~0.951);以RDW≥14.5%为诊断AP死亡风险指标的cut-off值,敏感度为71.43%(95%CI:41.90%~91.60%),特异度为89.40%(95%CI:83.40%~93.80%);AP患者RDW水平与网织红细胞百分比(Ret%)、未成熟网织红细胞比率(IFR)、中荧光强度网织红细胞比率(MFR)、高荧光强度网织红细胞比率(HFR)呈正相关(r=0.376、0.502、0.468、0.475,P<0.01),与低荧光强度网织红细胞比率(LFR)呈负相关(r=-0.502,P<0.01)。结论 RDW水平是早期预测AP患者死亡风险的一个较好指标,其升高程度与Ret生成密切相关。

Objective To investigate the value of RDW for predicting death risk in the patients with acute pancreatitis（AP）and its correlation with the Ret parameters.Methods A total of 164 patients with AP in the emergency surgery of Second Xiangya Hospital of Central South University from March 2015 to May 2015 were selected,including 151 survival cases and 13 death cases,and other 175 healthy people were selected as the control group.The venous blood was collected for detecting whole blood RDW and Ret parameters by using the Sysmex XN-1000 automatic blood analyzer.The inter-group comparison was performed by MannWhitney U and Kruskal-Wallis H tests;the diagnostic value of RDW for AP death risk was evaluated by receiver operating characteristic（ROC）curve and area under curve（AUC）.Results The RDW level in the AP death group was[15.7%（14.1%-21.8%）],which was significantly higher than that of AP survive group[13.3%（12.7%-14.5%）],the difference was statistically significant（Z=40.02,P〈0.05）;AUC of RDW ROC curve for diagnosing death risk was 0.835（95%CI：0.786-0.951）;With the cutoff value of RDW for diagnosing the AP death risk as≥14.5%,the sensitivity was 71.43%（95%CI：41.90%-91.60%）and specificity was 89.40%（95%CI：83.40%-93.80%）;the RDW level of AP patients was positively correlated with Ret%,IFR,MFR and HFR（r=0.376,0.502,0.468,0.475,P〈0.01）,and was negatively correlated with LFR（r=-0.502,P〈0.01）.Conclusion The RDW level is a good indicator for early predicting AP death risk,its elevated degree is closely correlated with Ret generation.