老年脓毒症患者红细胞分布宽度与病情程度的相关性

Correlation between red cell distribution width and illness severity in elderly patients with sepsis

目的探讨老年脓毒症患者血浆红细胞分布宽度(RDW)与病情严重程度的相关性。方法选取129例老年脓毒症患者并分别根据否合并休克、入院7 d内的预后情况进行分组。根据是否合并休克分为无休克组102例及休克组27例;按入院7 d内的预后情况分为存活组93例和死亡组36例。比较无休克组和休克组的RDW及血乳酸、C反应蛋白(CRP)、降钙素原(PCT)、序贯器官衰竭评估(SOFA)及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分;比较存活组和死亡组上述指标情况;对RDW与血乳酸、SOFA、APACHEⅡ评分分别进行相关回归分析。结果无休克组与休克组患者RDW、血乳酸、SOFA及APACHEⅡ评分比较,差异有统计学意义(P<0.05或P<0.01)。存活组和死亡组患者RDW、血乳酸、PCT、SOFA及APACHEⅡ评分比较,差异有统计学意义(P<0.05或P<0.01)。RDW与PCT、SOFA及APACHEⅡ评分存在正性相关关系。结论老年脓毒症患者RDW与病情严重程度存在相关性,具有重要的临床意义。

Objective To investigate the correlation between plasma red cell distribution width(RDW)and illness severity in elderly patients with sepsis.Methods A total of 129 elderly patients with sepsis were divided into different groups according to whether they had shock or not and the prognosis within seven days after admission.According to whether there was shock or not,the patients were divided into non-shock group(n=102)and shock group(n=27).According to the prognosis within seven days after admission,the patients were divided into survival group(n=93)and death group(n=36).RDW,blood lactic acid,C-reactive protein(CRP),procalcitonin(PCT),Sequential Organ Failure Assessment(SOFA)and Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱscores were compared between the non-shock group and the shock group.The above indexes were compared between the survival group and the death group.RDW and blood lactic acid,SOFA as well as APACHEⅡscores were analyzed by correlation regression.Results RDW,blood lactic acid,SOFA and APACHEⅡscores showed significant differences between the the non-shock group and the shock group(P<0.05 or P<0.01).RDW,blood lactic acid,PCT,SOFA and APACHEⅡscores showed significant differences between the survival group and the death group(P<0.05 or P<0.01).RDW was positively correlated with PCT,SOFA and APACHEⅡscores.Conclusion RDW in elderly patients with sepsis is correlated with the severity of the disease,which has important clinical significance.