上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

红细胞分布宽度对住院特发性间质性肺炎患者预后的影响

邹晓1，倪颖梦2，陈巍2   

  1. 1.浙江省杭州市富阳区中医医院内科， 杭州 311400； 2.上海交通大学 医学院附属瑞金医院呼吸科， 上海 200025
  • 出版日期:2015-08-28 发布日期:2015-09-30
  • 作者简介:邹晓（1981—）， 女， 主治医师， 硕士; 电子信箱: 17645019@qq.com。

Effects of red cell distribution width on prognosis of inpatients with idiopathic interstitial pneumonias

ZOU Xiao1, NI Ying-meng2, CHEN Wei2   

  1. 1.Department of Medicine, Fuyang District Hospital of Traditional Chinese Medicine, Hangzhou 311400, China； 2.Department of Pulmonary Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2015-08-28 Published:2015-09-30

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摘要：

目的  探讨红细胞分布宽度(RDW)与特发性间质性肺炎(IIPs)预后的相关性。方法  经诊断明确的IIPs患者61例，以死亡/生存作为观察终点对患者进行分组，记录两组患者的临床资料，分析IIPs的危险因素，探讨RDW与IIPs预后的相关性。结果  61例患者男33例，女28例，男女比例为1.2∶1，平均年龄(64.60±16.33)岁，死亡组35例，生存组26例。与生存组相比，死亡组平均年龄更高(P=0.004)、出现呼吸衰竭更明显(P=0.002)。所有患者的RDW基线值为(15.12±1.71)%，RDW末次值为(16.30±2.54)%。死亡组RDW基线值和末次值分别为(15.95±1.50)%和(17.84±2.26)%，均明显高于生存组(P=0.000)。Logistic多变量分析显示，在控制性别及年龄因素的基础上，RDW是IIPs预后的独立预测因素。RDW判断IIPs预后的界值为15.70％，受试者工作特征曲线（ROC曲线）下面积为0.94(95%CI：1.61～1.95)，判断IIPs预后的敏感度为88.60%，特异度为96.20%；RDW≥15.70%组死亡率明显高于RDW<15.70%组(P=0.000)。结论  RDW与IIPs病变的严重程度独立相关，是IIPs预后的独立预测因素。

关键词: 特发性间质性肺炎, 红细胞分布宽度, 相关性

Abstract:

Objective  To explore the correlation between red cell distribution width (RDW) and prognosis of idiopathic interstitial pneumonias (IIPs). Methods  A total of 61 patients with confirmed diagnosis of IIPs were divided into the survival group and death group by using death/survival as end point of observation. Their clinical data were recorded. The risk factors of IIPs were analyzed and the correlation between RDW and prognosis of IIPs was explored. Results  Among 61 patients, 33 were males and 28 were females, the ratio of male and female was 1.2∶1, and the average age was 64.60±16.33. Compared with the survival group (n=26), the average age of death group (n=35) was higher (P=0.004) and respiratory failure was severer (P=0.002). The baseline value of RDW of all patients was (15.12±1.71)% and last value of RDW was (16.30±2.54)%. The baseline value and last value of RDW of the death group were (15.95 ± 1.50)% and (17.84±2.26)% and significantly higher than those of the survival group (P=0.000).  Logistic multivariate analysis showed that RDW was an independent factor for predicting the prognosis of IIPs based on gender and age being controlled. The threshold value for predicting the prognosis of IIPs by RDW was 15.70% and the area under receiver operating characteristic (ROC) curve was 0.94 (95%CI: 1.61-1.95) with the sensitivity of 88.60% and specificity of 96.20%. The mortality of patients with RDW≥ 15.70% was significantly higher than that of patients with RDW<15.70% (P=0.000). Conclusion  RDW independently correlates with severity of IIPs and is an independent factor for predicting the prognosis of IIPs.

Key words: idiopathic interstitial pneumonias, red cell distribution width, correlation