首页|ICU多重耐药菌肺部感染患者入院24小时内红细胞分布宽度与30天内预后的关系

ICU多重耐药菌肺部感染患者入院24小时内红细胞分布宽度与30天内预后的关系

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目的 研究红细胞分布宽度(RDW)在重症监护病房(ICU)多重耐药菌(MDRO)肺部感染患者预后评估中的作用。方法 选取2021年1月-2022年12月某院ICU收治的MDRO肺部感染患者,根据患者预后分为预后良好组和预后不良组。比较两组患者的基本资料、红细胞分布宽度[红细胞分布宽度变异系数(RDW-CV)、红细胞分布宽度标准差(RDW-SD)]、D-二聚体(D-dimer)、降钙素原(PCT)、超敏肌钙蛋白(TNTsh)、N末端-B型尿钠肽前体(NT-proBNP)、血沉(ESR)、C反应蛋白(CRP)、白细胞介素-6(IL-6)等血清学指标。采用单因素t检验及多因素logistic回归分析血清学指标与MDRO肺部感染患者预后的关联因素,绘制受试者工作特征(ROC)曲线评估RDW对MDRO肺部感染患者预后的预测效能。结果 共纳入275例MDRO肺部感染病例;年龄22~99岁;预后良好组181例(65。8%),预后不良组94例(34。2%)。预后不良组PCT、D-dimer、RDW-CV、RDW-SD、TNTsh、NT-proBNP水平高于预后良好组,差异均有统计学意义(均P<0。05);多因素logistic回归分析显示RDW-CV[OR=19。011,95%CI(5。247~68。882),P<0。05]、RDW-SD[OR=13。693,95%CI(3。820~49。087),P<0。05]增高为MDRO肺部感染患者预后不良的关联因素;ROC曲线结果显示,RDW-CV、RDW-SD曲线下面积分别为0。901、0。896,最佳截断值为14。45%、49。60%。结论 本研究提示RDW值与MDRO肺部感染患者的疾病结局密切相关,有望成为其预后的评估指标之一,实现提前干预和风险评估价值。
Relationship between red cell distribution width within 24 hours and 30-day prognosis in ICU patients with multidrug-resistant pulmonary infection
Objective To study the role of red blood cell distribution width(RDW)in the prognosis evaluation of multidrug-resistant organism(MDRO)pulmonary infection(PI)in patients in intensive care unit(ICU).Methods Patients with MDRO PI in the ICU of a hospital from January 2021 to December 2022 were selected,they were di-vided into good prognosis group and poor prognosis group based on the prognosis.Basic information and serological indicators between two groups of patients were compared,including RDW(RDW coefficient of variation[RDW-CV],RDW standard deviation[RDW-SD]),D-dimer,procalcitonin(PCT),high-sensitivity troponin(TNTsh),N-terminal pro-B-type natriuretic peptide(NT-proBNP),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),and interleukin-6(IL-6).Univariate t-test and multiple logistic regression were adopted to analyze the cor-relation factors between serological indicators and the prognosis of MDRO PI patients,receiver operating characte-ristic(ROC)curves were used to evaluate the predictive efficacy of RDW on the prognosis of MDRO PI patients.Results A total of 275 cases of MDRO PI were included in analysis,age range from 22 to 99 years old;181 cases(65.8%)were in good prognosis group,94 cases(34.2%)in poor prognosis group.The levels of PCT,D-dimer,RDW-CV,RDW-SD,TNTsh,and NT-proBNP in the poor prognosis group were all higher than those in the good prognosis group,differences were all statistically significant(all P<0.05).Multivariate logistic regression analysis showed that the increase of RDW-CV(OR-19.011,95%CI[5.247-68.882],P<0.05)and RDW-SD(OR=13.693,95%CI[3.820-49.087],P<0.05)were associated with poor prognosis in patients with MDRO PI.ROC curve results showed that the areas under the curve of RDW-CV and RDW-SD were 0.901 and 0.896,respec-tively,with optimal cutoff values of 14.45%and 49.60%,respectively.Conclusion This study suggests that RDW value is closely related to the disease outcome of MDRO PI patients,and is expected to become one of the prog-nostic evaluation indicators,achieve early intervention and risk assessment.

red blood cell distribution widthmultidrug-resistant organismpulmonary infectionprognosisintensive care unit

欧阳娜、王花芹、王敏、吴俊

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中南大学湘雅二医院感染控制中心,湖南长沙 410011

中南大学湘雅二医院重症医学科,湖南长沙 410011

中南大学湘雅二医院检验科,湖南长沙 410011

中南大学湘雅二医院信息科,湖南长沙 410011

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红细胞分布宽度 多重耐药菌 肺部感染 预后 重症监护病房

2024

中国感染控制杂志
中南大学

中国感染控制杂志

CSTPCD北大核心
影响因子:2.112
ISSN:1671-9638
年,卷(期):2024.23(11)