| 红细胞分布宽度与血小板计数比值对脓毒症患者的预后分析 |
| 投稿时间：2024-08-09 修订日期：2024-08-27 点此下载全文 |
| 引用本文：安鹏夷,刘栩晗,杨柳,顾宫,杨初蔚.红细胞分布宽度与血小板计数比值对脓毒症患者的预后分析[J].医学研究杂志,2025,54(1):116-121 |
| DOI：
10.11969/j.issn.1673-548X.2025.01.022 |
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| 基金项目:辽宁省大连市登峰计划科研项目 |
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| 中文摘要:目的 探讨红细胞分布宽度(red cell distribution width,RDW)与血小板计数(platelet count,PLT)比值(red blood cell distribution width to platelet count ratio,RPR)与脓毒症(sepsis)患者预后的关系。方法 回顾性分析2010年1月1日~2023年12月31日于大连医科大学附属第二医院住院并诊断脓毒症的2082例患者的临床资料。根据患者的90天预后情况分为存活组和死亡组,并比较各组的临床资料。采用Spearman相关性分析探究RPR与脓毒症相关指标的相关性。应用COX回归分析脓毒症患者死亡的影响因素,受试者工作特征(receiver operating characteristic,ROC)曲线分析RPR对脓毒症患者预后的预测价值,并根据RPR截断值将患者分为两组,对其使用Kaplan-Meier法对各亚组进行生存分析。结果 共有857例患者发生死亡,总病死率为41.16%。Spearman相关性分析结果示RPR与白细胞计数、C反应蛋白、降钙素原、SOFA评分呈正相关(P均＜0.05)。COX多因素分析显示,RPR [HR=1.191(95% CI:1.160~1.224)]是影响病死率的独立危险因素(P均＜0.05)。ROC曲线结果显示,RPR≥0.142是判断患者预后的最佳截断值,曲线下面积0.966。Kaplan-Meier生存分析表明,RPR≥0.142的脓毒症患者死亡风险明显升高,其中位生存天数为9.365(95% CI:8.354~10.375)天。结论 RPR是预测脓毒症患者死亡的独立危险因素,RPR≥0.142是判断预后的最佳截断值。 |
| 中文关键词:脓毒症 红细胞分布宽度与血小板计数比值 预后 相关性 预测价值 |
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| Analysis of Prognosis for Sepsis Patients Based on the Red Blood Cell Distribution Width to Platelet Count Ratio. |
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| Abstract:Objective To explore the relationship between the ratio of red blood cell distribution width to platelet count (RPR) and the prognosis of sepsis patients. Methods The clinical data of 2082 patients admitted to the Second Affiliated Hospital of Dalian Medical University and diagnosed with sepsis from January 1,2010 to December 31,2023 were retrospectively analyzed. Based on the 90-day prognosis, the patients were divided into a survival group and a death group, and the clinical data of each group were compared. Spearman correlation analysis was employed to examine the correlation between RPR and sepsis-related indicators. COX regression was used to analyze the influencing factors of death in sepsis patients, and the receiver operating characteristic (ROC) curve was utilized to analyze the predictive value of RPR for the prognosis of sepsis patients. Patients were divided into two groups according to the RPR cut-off value, and survival analysis was performed for each subgroup using the Kakaplan-Meier method. Results A total of 857 patients died, with an overall fatality rate of 41.16%. Spearman correlation analysis indicated that RPR was positively correlated with white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), and Sequential Organ Failure Assessment (SOFA) scores (all P<0.05). COX multivariate analysis showed that RPR [HR=1.191 (95% CI:1.160-1.224)] was an independent risk factor for mortality (all P<0.05). The results of the ROC curve demonstrated that RPR≥0.142 was the optimal threshold value for judging the prognosis of patients, with an area under the curve of 0.966. Kaplan-Meier survival analysis revealed that sepsis patients with RPR≥0.142had a significantly higher risk of death, with a median survival of 9.365 (95% CI:8.354-10.375)days. Conclusion RPR is an independent risk factor for predicting death in sepsis patients. Moreover, RPR≥0.142 is the optimal threshold for predicting prognosis. |
| keywords:Sepsis Red blood cell distribution width to platelet count ratio Prognosis Correlation Predictive value |
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