临床经验 Open Access
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
世界华人消化杂志. 2016-01-18; 24(2): 305-310
在线出版日期: 2016-01-18. doi: 10.11569/wcjd.v24.i2.305
红细胞分布宽度对重症急性胰腺炎患者院内死亡的预测价值
杨涓, 郑盛, 刘汉屈, 唐映梅
杨涓, 郑盛, 刘汉屈, 云南省第三人民医院消化内科 云南省昆明市 650011
唐映梅, 昆明医科大学附属第二医院肝病中心 云南省昆明市 650000
杨涓, 主治医师, 主要从事肝胆胰疾病的基础与临床研究.
基金项目: 云南省自然科学基金资助项目, No. 2012FD095; 云南省教育厅科研基金重点资助项目, Nos. 2014Z125, 2015Z146.
作者贡献分布: 课题设计由郑盛负责; 研究过程由杨涓、刘汉屈及唐映梅完成; 论文写作由杨涓与郑盛共同完成.
通讯作者: 郑盛, 副主任医师, 650011, 云南省昆明市北京路292号, 云南省第三人民医院消化内科. zheng_sheng523@163.com
电话: 0871-63197208
收稿日期: 2015-10-21
修回日期: 2015-12-05
接受日期: 2015-12-14
在线出版日期: 2016-01-18

目的: 探讨红细胞分布宽度(red blood cell distribution width, RDW)对重症急性胰腺炎(severe acute pancreatitis, SAP)患者院内死亡的预测价值.

方法: 回顾性选择2013-01/2015-06云南省第三人民医院收治的SAP患者114例纳入研究, 按住院期间是否死亡分为死亡组和非死亡组. 分析两组患者的基本临床资料, 通过二分类Logistic回归分析得出院内死亡的危险因素, 绘制ROC曲线, 分析RDW对SAP患者院内死亡的预测价值.

结果: 死亡组的血糖、血钙、血肌酐、氧合指数、白蛋白、乳酸脱氢酶、血红蛋白、红细胞压积、RDW、APAPHEⅡ评分与Ranson评分等指标与非死亡组比较差异有统计学意义(P<0.05); 二分类Logistic回归分析显示, RDW、APAPHEⅡ评分、Ranson评分、白蛋白、氧合指数、血肌酐等指标为院内死亡的独立危险因素(P<0.05); ROC曲线分析显示, RDW曲线下面积为0.907(95%CI: 0.928-0.968, P = 0.000), APAPHEⅡ评分为0.864(95%CI: 0.812-0.915, P = 0.000), 氧合指数为0.848(95%CI: 0.785-0.833, P = 0.001).

结论: RDW是SAP患者预后的对立预测因子, 对SAP患者院内死亡的预测价值较高.

关键词: 红细胞分布宽度; 重症急性胰腺炎; ROC曲线; 预后
引文著录: 杨涓, 郑盛, 刘汉屈, 唐映梅. 红细胞分布宽度对重症急性胰腺炎患者院内死亡的预测价值. 世界华人消化杂志 2016; 24(2): 305-310
Clinical value of red blood cell distribution width in predicting in-hospital death of patients with severe acute pancreatitis
Juan Yang, Sheng Zheng, Han-Qu Liu, Ying-Mei Tang
Juan Yang, Sheng Zheng, Han-Qu Liu, Department of Digestive Diseases, the Third People's Hospital of Yunnan Province, Kunming 650011, Yunnan Province, China
Ying-Mei Tang, Center for Liver Diseases, the Second Affiliated Hospital of Kunming Medical University, Kunming 650000, Yunnan Province, China
Supported by: Natural Science Foundation of Yunnan Province, No. 2012FD095; Research Fund of Education Department of Yunnan Province, Nos. 2014Z125 and 2015Z146.
Correspondence to: Sheng Zheng, Associate Chief Physician, Department of Digestive Diseases, the Third People's Hospital of Yunnan Province, 292 Beijing Road, Kunming 650011, Yunnan Province, China. zheng_sheng523@163.com
Received: October 21, 2015
Revised: December 5, 2015
Accepted: December 14, 2015
Published online: January 18, 2016

AIM: To investigate the value of red blood cell distribution width (RDW) in predicting in-hospital death of patients with severe acute pancreatitis (SAP).

METHODS: One hundred and fourteen SAP patients were divided into either a death or a non-death group, according to whether hospitalization death occurred. Clinical data for the two groups of patients were analyzed. The risk factors for in-hospital death were classified by binary logistic regression analysis. The value of RDW in predicting in-hospital death in patients with SAP was assessed by ROC curve analysis.

RESULTS: The differences in glucose, calcium, creatinine, oxygenation index, albumin, lactate dehydrogenase, hemoglobin, red blood cells deposit, RDW, APACHEII score, and Ranson score between the death group and non-death group were statistically significant (P < 0.05). Binary classification logistic regression analysis showed that RDW, APACHEII score, Ranson score, albumin, oxygenation index, and creatinine were independent risk factors for in-hospital death (P < 0.05); the RDW regression coefficient was 0.156, and odds ratio (OR) was 1.170 (95%CI: 1.004-1.325, P = 0.008). ROC curve analysis showed that the area under the curve was 0.907 for RDW (95%CI: 0.928-0.968, P = 0.000); 0.864 for APACHEII score (95%CI: 0.812-0.915, P = 0.000); and 0.848 for oxygenation index (95%CI: 0.785-0.833, P = 0.001).

CONCLUSION: RDW is an independent predictor of prognosis in patients with SAP, and has high value in predicting in-hospital death of SAP patients.

Key Words: Red blood cell distribution width; Severe acute pancreatitis; Receiver operating characteristic curve; Prognosis
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