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目的:探讨小儿重症肺炎红细胞体积分布宽度(RDW)与患儿近期预后的相关性。方法:选择107例重症肺炎患儿为研究对象,检测患儿入院时RDW水平,记录相关实验室检查指标及住院后28d的转归情况,将患者分为死亡组和存活组,高RDW组和正常RDW组,分析各组之间相关指标的差异,并探讨RDW与患儿近期预后的关系。结果:死亡组患儿的入院急性病生理学和长期健康评价评分Ⅱ(APACHEⅡ)评分、降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)、白细胞计数(WBC)、中性粒细胞百分比(PMN)、血沉(ESR)高于存活组(P<0.05),RDW水平亦高于存活组(P<0.05);高RDW组患儿APACHEⅡ评分、PCT、hs-CRP、WBC、PMN、ESR高于正常RDW组,死亡率亦高于正常RDW组(P<0.05)。Logistic回归分析显示RDW水平是重症肺炎患儿近期死亡的独立危险因素(OR=2.025,95%CI:1.252~4.243,P<0.05);ROC曲线分析显示:RDW水平预测重症肺炎患儿死亡的ROCAUC为0.801,灵敏度为82.0,特异度为74.4,最佳诊断截点为16.35%。结论:RDW水平可能是重症肺炎患儿近期预后不良的独立危险因素,并对患儿预后可能具有较好的预测价值。
Objective: To investigate the correlation between pediatric severe pneumonia erythrocyte volume distribution width (RDW) and the recent prognosis of children. Methods: A total of 107 children with severe pneumonia were selected as research objects. The RDW level of children admitted to hospital were detected. The related laboratory indexes and the outcome of 28 days after hospitalization were recorded. The patients were divided into death group and survival group, Normal RDW group, analysis of the differences between the relevant indicators in each group, and explore the relationship between RDW and the recent prognosis of children. Results: APACHEⅡ, PCT, hs-CRP, WBC and neutrophil in children with death were higher than those in control group (P <0.05), and the RDW was also higher than that of the surviving group (P <0.05). The APACHEⅡscore, PCT, hs-CRP, WBC and PMN , ESR was higher than normal RDW group, the mortality rate was also higher than normal RDW group (P <0.05). Logistic regression analysis showed that RDW level was an independent risk factor for recent death in children with severe pneumonia (OR = 2.025, 95% CI: 1.252-4.43, P <0.05). ROC curve analysis showed that RDW level predicted ROCAUC in children with severe pneumonia Was 0.801, the sensitivity was 82.0, the specificity was 74.4, and the best diagnosis cutoff was 16.35%. Conclusion: The level of RDW may be an independent risk factor for the recent poor prognosis in children with severe pneumonia, and may have a good predictive value for the prognosis of children.