红细胞分布宽度对老年社区获得性肺炎预后的探讨

摘要

目的：探讨红细胞分布宽度（ red cell distribution width， RDW）对老年社区获得性肺炎（ community acquired pneumonia， CAP）预后的预测价值。方法回顾性分析安徽医科大学第一附属医院急诊内科及急诊重症监护室205例老年CAP患者。根据入院时RDW将患者分为4组，对比各组间相关指标（ CURB－65计分、器官衰竭及ICU入住率、住院天数、30 d死亡率）的差异，并就RDW对老年CAP住院患者死亡预测价值进行统计学分析。结果 CURB－65计分、器官衰竭发生率、ICU入住率、30 d死亡率4组间进行两两比较，差异有统计学意义（ P＜0．05）；RDW预测老年CAP死亡的受试者工作曲线（ ROC）的曲线下面积（ AUC）＝0．75。结论 RDW可作为临床对老年CAP患者病情严重程度的评估指标之一，对预测老年CAP患者死亡预后有一定意义。%Objective To investigate the predictive value of red cell distribution width ( RDW) in the aged patients with community acquired pneumonia(CAP). Methods 205 elderly patients with CAP from the Emergency Medical Ward and Emergency Intensive Care Unit of the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed.According to RDW on admission, the patients with CAP were divided into four groups.CURB-65 scores, organ failure, intensive care unit occupancy, the duration of hospital stay and 30 -day mortality outcomes were detected and compared among the groups, and RDW was statistically analyzed to predict mortality in these patients. Results Among the four groups, CURB-65, incidence of organ failure, ICU occupancy rate and 30-day mortality were statistically different (P<0.05).ROC curve was drawn to evaluate the predictive role of RDW in elderly CAP death, the area under the curve ( AUC) =0.75.Conclusion RDW can be used as a clinical evaluation of the severity of disease in elderly patients with CAP of one of the indicators.It is of some significance to predict prognosis of death in elderly patients with CAP.