红细胞分布宽度对慢性阻塞性肺疾病急性加重患者的预后评估

Analysis of the Relationship between Red Blood Cell Distribution Width and the Prognosis of AECOPD

目的:探讨AECOPD患者外周血红细胞分布宽度(Red blood cell distribution width,RDW)与预后的关系。方法:回顾性分析2015年1月—2017年12月期间苏州市相城人民医院呼吸科收住入院的AECOPD患者的临床资料。对患者一般临床资料进行记录,包括年龄、性别、既往吸烟史及COPD病程;入院24h内感染相关指标如白细胞计数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT);入院第1、2、3、5、7天的RDW分别记为RDW1、RDW2、RDW3、RDW5、RDW7。记录患者的预后指标28d病死率。以入科后28d生存情况分为死亡组及存活组。据RDW是否> 15%分为高RDW组和低RDW组。结果:研究期间共464例AECOPD患者入院,入院28d内有38例(8. 19%)死亡,426例(91. 81%)存活。死亡组RDW1、WBC、CRP及PCT均比存活组高,且差异有统计学意义(P <0. 05)。高RDW组的28d病死率显著高于低RDW组(11. 02%VS 4. 76%,P=0. 014)。死亡组RDW均值入院后逐步上升,而存活组均值变化无线性趋势。结论:RDW是AECOPD患者住院28d死亡的高危因素,动态监测RDW水平有助于评估AECOPD近期预后。

Objective:To explore the relationship between red blood cell distribution width and the prognosis of AECOPD.Methods:A retrospective observational cohort study was carried out in our department from January 2015 to December 2017.All hospitalized AECOPD patients were enrolled in our department.Base data were collected from the hospital database.Subject’s characteristics,hemogram parameters,infection-related indicators on admission,the RDWs on the 1st,2nd,3rd,5th,and 7th days after admission duration of hospital stay,and the 28-day mortality were recorded.The 28-day survival after admission was divided into death group and survival group.According to whether RDW is greater than 15%,it is divided into high RDW group and low RDW group.Results:A total of 464 AECOPD patients were admitted to the hospital during the study period,38(8.19%)died within 28 days of admission,and 426(91.81%)survived.RDW1,WBC,CRP and PCT in death group were all higher than the survival group with a statistical difference(P<0.05).The 28-day mortality was significantly higher in the high RDW group than in the low RDW group(11.02%VS 4.76%,P=0.014).The mean value of RDW in the death group gradually increased after admission,while the mean value of the survival group changed wirelessly.Conclusion:RDW is a risk factor for 28-day mortality in AECOPD patients.Dynamic monitoring of RDW levels is useful in assessing the short-term prognosis of AECOPD.