Objective To explore the relationship of red blood cell distribution width (RDW) with severity and prognosis in children with sepsis. Methods The RDW, clinical features and prognosis of 494 sepsis children were retrospectively ana-lyzed. Results The RDW was increased in 305 sepsis children (61.74%) among whom 49.30%in sepsis group, 60.27%in sever sepsis group and 83.46%in septic shock group. The difference was signiifcant (P<0.001). The mortality of RDW increased children among three groups was 1.89%, 20.45%, 67.57%, and it was signiifcantly different (P<0.001). The rates of increased RDW was 56.15%in 374 survived cases and 79.17%in 120 died cases, and the difference was signiifcant (P<0.001). Pediatric critical illness score (PCIS) was negatively correlated with RDW (P<0.001), while mortality was positively correlated with RDW (P<0.001). Conclusions The rate of increased RDW is high in children with severe sepsis and septic shock and the level of RDW is closely related to the prognosis of patients.%目的：探讨红细胞体积分布宽度（RDW）与脓毒症患儿病情严重程度及预后的关系。方法回顾性分析494例脓毒症患儿的RDW、临床特征及预后。结果305例脓毒症患儿RDW升高，发生率61.74％，其中脓毒症组49.30%，严重脓毒症组60.27%，脓毒性休克组83.46%，差异有统计学意义（P<0.001）；三组中RDW升高患儿的病死率分别为1.89%、20.45%、67.57%，差异有统计学意义（P<0.001）；374例存活脓毒症患儿中56.15%RDW升高，120例死亡患儿中79.17%升高，差异有统计学意义（P<0.001）；脓毒症患儿危重病例评分（PCIS）与RDW升高呈负相关（P<0.001），病死率与RDW升高呈正相关（P<0.001）。结论 RDW升高与脓毒症患儿疾病严重程度及预后密切相关。[临床儿科杂志,2013,31(10)：946-948]
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