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红细胞体积分布宽度在心脏停搏患者预后中的评估价值OA

Evaluation value of red cell volume distribution width in prognosis of patients with cardiac arrest

中文摘要英文摘要

目的 探讨红细胞体积分布宽度(red cell volume distribution width,RDW)对心脏停搏(cardiac arrest,CA)患者预后的评估价值.方法 回顾性分析 2018 年 1 月至 2022 年 10 月湖州市中心医院重症监护室(intensive care unit,ICU)收治的 146 例CA患者的临床资料,根据ICU住院期间预后将患者分为存活组和死亡组,比较两组患者的临床资料,采用多因素 Logistic 回归分析影响 CA 患者预后的危险因素.采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)评估RDW对CA患者预后的预测效能.Kaplan-Meier法绘制患者生存曲线.结果 共纳入 146 例CA患者,其中存活49例,死亡97例,死亡率66.44%.死亡组患者的急性生理学和慢性健康状况评价Ⅱ评分、RDW、血钠、丙氨酸转氨酶均显著高于存活组,心肺复苏时间显著长于存活组,ICU住院时间显著短于存活组(P<0.05).多因素Logistic回归分析结果显示,RDW、心肺复苏时间均是CA患者ICU住院期间死亡的独立危险因素(P<0.05).ROC曲线结果显示RDW预测CA患者死亡的曲线下面积为 0.742,最佳截断值为 13.95%,敏感度 59.8%,特异性 85.7%.低RDW患者的 1 年累积生存率显著高于高RDW患者(χ2=18.757,P<0.001).结论 RDW是预测CA患者ICU住院期间死亡的独立危险因素.

Objective To evaluate the value of red cell volume distribution width(RDW)in the prognosis of patients with cardiac arrest(CA).Methods Clinical data of 146 CA patients admitted to intensive care unit(ICU)of Huzhou Central Hospital from January 2018 to October 2022 were retrospectively analyzed,and the patients were divided into survival group and death group according to the prognosis during ICU stay.The clinical data of two groups were compared,and the risk factors affecting the prognosis of CA patients were analyzed by multivariate Logistic regression.Receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of RDW in CA patients.The survival curve was plotted by Kaplan-Meier method.Results A total of 146 CA patients were included in the analysis,among which 49 patients survived and 97 patients died,the mortality rate of CA patients in ICU was 66.44%.The scores of acute physiology and chronic health evaluation Ⅱ,RDW,blood sodium and alanine aminotransferase in death group were significantly higher than those in survival group,the time of cardiopulmonary resuscitation was significantly longer than that in survival group,and the length of ICU stay was significantly shorter than that in survival group(P<0.05).Multivariate Logistic regression analysis showed that RDW and time of cardiopulmonary resuscitation were independent risk factors for predicting death during ICU stay in CA patients(P<0.05).ROC curve results showed that RDW predicted death in CA patients with the area under curve of 0.742,the best cut-off value was 13.95%,the sensitivity was 59.8%,and the specificity was 85.7%.Patients with low RDW had significantly higher one-year cumulative survival rate than those with high RDW(χ2=18.757,P<0.001).Conclusion RDW was an independent risk factor for predicting death during ICU stay in CA patients.

叶莉莉;钟磊;姬晓伟;陈春荣;谢波

浙江大学医学院附属湖州医院(湖州市中心医院)重症医学科,浙江湖州 313000浙江大学医学院附属湖州医院(湖州市中心医院)儿科,浙江湖州 313000

临床医学

红细胞体积分布宽度;心脏停搏;预后

Red cell volume distribution width;Cardiac arrest;Prognosis

《中国现代医生》 2024 (001)

7-10,14 / 5

浙江省基础公益研究计划项目(LGD20H150001)

10.3969/j.issn.1673-9701.2024.01.002

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