红细胞分布宽度在医院获得性肺炎实验室诊断中的价值评估

Evaluation of RDW in the Laboratory Diagnosis of Hospital-acquired Pneumonia.

目的本研究探讨红细胞分布宽度(RDW)在医院获得性肺炎(HAP)实验室诊断及其感染菌群中的价值评估。方法回顾性分析住院患者的痰培养结果及其相应的血常规衍生参数RDW,痰培养结果分为痰培养阳性组(HAP)和痰培养阴性组(疑似HAP),随机抽取同期健康体检者作为对照组,并采用受试者工作特征曲线(ROC)及曲线下面积(AUC)分析RDW对HAP及感染菌群的诊断价值。结果与对照组[12.85(12.27,13.30)]和痰培养阴性组[13.15(12.57,14.20)]比较,住院患者痰培养阳性组的RDW异常(升高)率(58.90%)显著升高,RDW水平[15.40(14.20,16.60)]也显著升高;痰培养阳性组的菌群以革兰阴性杆菌为主,其次为革兰阳性球菌和真菌;阴性杆菌组的RDW水平[15.90(14.35,17.40)]与阳性球菌组[14.80(14.17,15.30)]和真菌组[14.90(14.05,16.17)]比较差异有统计学意义。ROC曲线分析显示,RDW诊断HAP感染的AUC为0.81;区分革兰阴性菌与革兰阳性菌及真菌的AUC分别为0.75和0.72。结论RDW可作为HAP及其感染菌群的辅助诊断,RDW将是一种很有前景的炎性生物学标志物。

Objective To evaluate the value of Red cell distribution width(RDW)in laboratory diagnosis and infectious flora of hospital-acquired pneumonia(HAP).Methods The sputum culture results of inpatients and their corresponding blood routine derived parameters,RDW,were retrospectively analyzed.Sputum culture results were divided into positive-culture group and negative-culture group.Meanwhile,healthy subjects were randomly selected as control group.The receiver operating characteristic curve(ROC)and area under the curve(AUC)were employed to analyze the diagnostic value of RDW for HAP and infectious flora.Results Compared with[12.85(12.27,13.30)]in control group and[13.15(12.57,14.20)]in negative group.Abnormality rate(58.90%)of RDW in positive group of hospitalized patients was significantly higher,and the RDW level[15.40(14.20,16.60)]was also significantly increased.The bacteria in positive group were mainly Gram-negative bacilli(G-b),followed by Gram-positive cocci(G+c)and fungi.RDW level of G-b group[15.90(14.35,17.40)]was significantly different from that of G+c group[14.80(14.17,15.30)]and fungal group[14.90(14.05,16.17)].ROC analysis suggested the AUC of RDW to diagnose HAP infection was 0.81;and the AUC for distinguishing G-b from G+c and fungi were 0.75 and 0.72,respectively.Conclusion RDW can be used as an auxiliary diagnosis of HAP and its infective flora,and it will be a promising inflammatory biomarker.