AECOPD患者红细胞分布宽度变化及对预后的评估价值

Changes of erythrocyte distribution width and its evaluation value on prognosis in patients with AECOPD

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者的红细胞分布宽度(RDW)变化情况,并分析其对预后评估的作用。方法选取该院2017年3月至2019年3月收治的AECOPD患者184例作为研究组,同期健康体检者184例作为健康对照组,同期收治的慢性阻塞性肺疾病(COPD)患者184例作为COPD组,比较3组研究对象的血常规及炎症因子检查结果,并进行相关性分析。根据RDW是否异常将研究组分为RDW异常组和RDW正常组,比较两组患者的存活情况。根据患者4周内存活情况将研究组分为死亡组和存活组,比较两组之间RDW变化情况。结果3组白细胞计数、RDW、C反应蛋白、降钙素原水平差异有统计学意义(P<0.05),且研究组患者RDW与白细胞计数、C反应蛋白、降钙素原呈正相关(r=0.617、0.583、0.422,P<0.05)。RDW异常患者4周内病死率为18.18%,显著高于RDW正常组患者(5.21%),差异有统计学意义(P<0.05);死亡组患者入院后第1、3、7天的RDW均显著高于存活组患者(P<0.05)。结论RDW是评估AECOPD患者疾病严重程度的重要指标,对患者近期生存状况的评估具有一定的临床意义。

Objective To investigate the changes of erythrocyte distribution width(RDW)in the patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to analyze its effect on the prognosis evaluation.Methods A total of 184 patients with AECOPD treated in the hospital from March 2017 to March 2019 were selected as the study group,and contemporaneous 184 persons undergoing healthy physical examination as the healthy control group,and 184 cases of COPD as the COPD group.The results of blood routine examination and inflammatory factors were compared among the three groups.The correlation analysis was performed.The study group was divided into the RDW abnormal group and RDW normal group.Then the survival situations were compared between these two groups.The study group was divided into the death group and survival group according to the survival situation within 4 weeks.Then the RDW change situations were compared between these two groups.Results There were statistically significant differences in WBC count,RDW,CRP and procalcitonin levels among the three groups(P<0.05),and the RDW was positively correlated with WBC count,CRP and procalcitonin levels in the study group(r=0.617,0.583,0.422,P<0.05);the mortality rate within 4 weeks in the patients with abnormal RDW was 18.18%,which was significantly higher than 5.21% in the patients with normal RDW,and the difference was statistically significant(P<0.05);RDW on 1,3,7 d after admission in the death group was significantly higher than that in the survival group(P<0.05).Conclusion RDW is an important index for evaluating the disease severity of AECOPD patients,which has a certain clinical significance in evaluating the recent survival status of AECOPD patients.