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[目的]探讨红细胞体积分布宽度(RDW)与老年重症肺炎(SCAP)预后的相关性.[方法]回顾性分析2013年6月至2015年12月74例老年 SCAP患者资料,根据出院是否存活分为存活组与死亡组,比较两组性别、年龄、入院当日急性生理和慢性健康状况评分Ⅱ (APACHE Ⅱ)、血小板(PLT)、血小板分布宽度(PDW)、白细胞计数(WBC)、血细胞比容(HCT)、平均红细胞体积(MCV)、血红蛋白(Hb),两组患者 d1、d3、d7的 RDW值,多因素回归分析临床预后的影响因素.[结果]死亡组 d1、d3、d7RDW逐步上升,而存活组均值变化无线性趋势.通过多因素回归分析显示,年龄、APACHE Ⅱ评分、RDW 及 RDW 进行性升高是老年SCAP患者死亡的危险因素(P <0.05).[结论]RDW是老年 SCAP死亡率的独立危险因素,RDW进行性增高提示预后不佳.“,”[Objective]To investigate the correlation between the distribution of red cell distribution width and the prognosis of the severe pneumonia of the elderly patients.[Methods]We performed a retrospective a-nalysis of 74 elderly patients with severe pneumonia in our hospital from June 2013 to December 2015.Accord-ing to the survival of discharge,the patients were divided into the survival group and death group.The records included gender,age,acute physiology and chronic heath evaluationⅡ (APACHE Ⅱ)score,WBC,HCT, MCV,Hb,PLT and PDW.RDW on day 1,3,and 7 were collected as well.Multivariate regression analysis of clinical prognostic factors was conducted.[Results]The mean RDW of d1,d3and d7in the death group in-creased gradually,however,the mean value of RDW of d1,d3and d7did not show a linear trend in the surviv-al group.Multivariate regression analysis showed that age,APACHE II score,RDW and progressive elevation of RDW were the independent risk factors of severe pneumonia in the elderly patients(P<0.05).[Conclusion]RDW was the independent risk factors for the mortality of severe pneumonia in the elderly patients,and the progressive increase of RDW suggests a poor prognosis.