红细胞分布宽度与老年支气管扩张症急性加重期严重程度的相关性分析
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摘要
目的探讨红细胞分布宽度(RDW)与老年支气管扩张症急性加重期严重程度的相关性。方法收集2015年1月至2018年10月成都市第二人民医院呼吸与危重症医学科住院216例老年支气管扩张症急性期加重期患者的病历资料。用支气管扩张严重度指数(BSI)对老年支气管扩张急性加重期病情严重度进行评估,将患者分为低危、中危和高危三组。收集同期50例老年体检者为健康对照组。记录BSI、RDW、降钙素原(PCT)、中性粒细胞百分比(NEU%)和C反应蛋白(CRP)水平。用Spearman相关性分析指标间的相关关系。通过一般线性回归构建方程,计算RDW的阈值,用多元线性回归分析BSI评分的影响因素。结果危险度分层越高,BSI评分越高,RDW、PCT、NEU%和CRP值也越高。RDW与PCT、NEU%、CRP呈正相关(r值分别为0.425、0.311、0.177,均P<0.05)。BSI评分与RDW、PCT、NEU%、CRP呈正相关(r值分别为0.425、0.394、0.650、0.578,均P<0.05)。RDW的阈值分别为11.45%、14.03%。多元线性回归分析显示RDW、PCT、NEU%、CRP均是BSI评分的影响因素,解释了BSI评分变异率的52.3%。结论 RDW与老年支气管扩张症急性加重期病情严重程度有关,可以预测老年支气管扩张症急性加重期严重程度。
Objective To investigate the relationship between the red blood cell distribution width(RDW) and the severity of acute exacerbation of bronchiectasis in elderly patients. Methods The clinical data of 216 elderly patients with acute exacerbation of bronchiectasis admitted from January 2015 to October of 2018 were analyzed retrospectively.The severity of acute exacerbation of bronchiectasis in the elderly was evaluated by bronchiectasis severity index(BSI)score. Meanwhile, 50 elderly people receiving qualified medical examination were collected as a healthy control group in the same period. The distributions of BSI score, RDW, procalcitonin(PCT), neutrophil percentage(NEU%) and C-reactive protein(CRP) were described in the patients with different risk degree. The severity of acute exacerbation of bronchiectasis in the elderly was evaluated by BSI. The patients were divided into three groups by BSI score: a low risk group, a middle risk group, and a high risk group. The indexes were described including the distribution of stratified BSI score, RDW, PCT, NEU%, CRP at different risk levels. The correlation of each index was analyzed by Spearman correlation. The threshold value of RDW was calculated by general linear regression, and the influencing factors of BSI score were analyzed by multivariate linear regression analysis. Results The higher the risk stratification, the higher the BSI score, RDW, PCT, NEU% and CRP were. RDW was positively correlated with PCT, NEU% and CRP(r values were0.425, 0.311, 0.177, respectively, P<0.05). BSI score was positively correlated with RDW, PCT, NEU%, and CRP(r values were 0.425, 0.394, 0.650, 0.578, respectively, P<0.05). RDW was positively correlated with PSI score(r=0.425, P<0.05). The thresholds of RDW were 11.45% and 14.03%. Multiple linear regression showed that RDW, PCT, NEU% and CRP were all influential factors of BSI score and explained 52.3% of the total mutation rate. Conclusion RDW is related to the severity of acute exacerbation of bronchiectasis in the elderly, and can predict the severity of acute exacerbation of bronchiectasis in the elderly.
Objective To investigate the relationship between the red blood cell distribution width(RDW) and the severity of acute exacerbation of bronchiectasis in elderly patients. Methods The clinical data of 216 elderly patients with acute exacerbation of bronchiectasis admitted from January 2015 to October of 2018 were analyzed retrospectively.The severity of acute exacerbation of bronchiectasis in the elderly was evaluated by bronchiectasis severity index(BSI)score. Meanwhile, 50 elderly people receiving qualified medical examination were collected as a healthy control group in the same period. The distributions of BSI score, RDW, procalcitonin(PCT), neutrophil percentage(NEU%) and C-reactive protein(CRP) were described in the patients with different risk degree. The severity of acute exacerbation of bronchiectasis in the elderly was evaluated by BSI. The patients were divided into three groups by BSI score: a low risk group, a middle risk group, and a high risk group. The indexes were described including the distribution of stratified BSI score, RDW, PCT, NEU%, CRP at different risk levels. The correlation of each index was analyzed by Spearman correlation. The threshold value of RDW was calculated by general linear regression, and the influencing factors of BSI score were analyzed by multivariate linear regression analysis. Results The higher the risk stratification, the higher the BSI score, RDW, PCT, NEU% and CRP were. RDW was positively correlated with PCT, NEU% and CRP(r values were0.425, 0.311, 0.177, respectively, P<0.05). BSI score was positively correlated with RDW, PCT, NEU%, and CRP(r values were 0.425, 0.394, 0.650, 0.578, respectively, P<0.05). RDW was positively correlated with PSI score(r=0.425, P<0.05). The thresholds of RDW were 11.45% and 14.03%. Multiple linear regression showed that RDW, PCT, NEU% and CRP were all influential factors of BSI score and explained 52.3% of the total mutation rate. Conclusion RDW is related to the severity of acute exacerbation of bronchiectasis in the elderly, and can predict the severity of acute exacerbation of bronchiectasis in the elderly.
引文
1Ringshausen FC, de Roux A, Diel R, et al. Bronchiectasis in Germany:a population-based estimation of disease prevalence. Eur Respir J, 2015, 46(6):1805-1807.
2 Quint JK, Millett ER, Joshi M, et al. Changes in the incidence,prevalence and mortality of bronchiectasis in the UK from 2004 to2013:a population-based cohort study. Eur Respir J, 2016, 47(1):186-193.
3 Kwak HJ, Moon JY, Choi YW, et al. High prevalence of bronchiectasis in adults:analysis of CT findings in a health screening program. Tohoku J Exp Med, 2010, 222(4):237-242.
4 Ellis HC, Cowman S, Fernandes M, et al. Predicting mortality in bronchiectasis using BSI and FRACED scores:a 19-year cohort study. Eur Respir J, 2016, 47(2):482-489.
5 Balta S, Demirkol S, Hatipoglu M, et al. Red cell distribution width is a predictor of mortality in patients with severe sepsis and septic shock. Am J Emerg Med, 2013, 31(6):989-990.
6 Salvagno GL, Sanchis-Gomar F, Picanza A, et al. Red blood cell distribution width:a simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci, 2015, 52(2):86-105.
7 张静,刘冬,许西琳,等.红细胞分布宽度与成人社区获得性肺炎严重程度的相关性分析.中国呼吸与危重监护杂志, 2018, 17(2):134-137.
8 葛均波,徐永健,梅长林,等.内科学.第8版.北京:人民卫生出版社, 2015, 37-40.
9 成人支气管扩张症诊治专家共识编写组.成人支气管扩张症诊治专家共识.中华结核和呼吸杂志, 2012, 35(7):485-492.
10 Chalmers JD, Goeminne P, Aliberti S, et al. The bronchiectasis severity index. An international derivation and validation study.Am J Respir Crit Care Med, 2014, 189(5):576-585.
11 陈荣昌,关伟杰,钟南山.支气管扩张症:需要更多的关注和研究.中华结核和呼吸杂志, 2017, 40(1):5-7.
12 盛伟利,张永祥,赵莹,等.支气管扩张严重度指数和FACED评分对支气管扩张症预后评估的比较.国际呼吸杂志, 2016,36(12):926-929.
13 中国医药教育协会感染疾病专业委员会.感染相关生物标志物临床意义解读专家共识.中华结核和呼吸杂志, 2017, 40(4):243-257.
14 杨德平,狄勇. PCT、WBC、CRP联合检测对早期细菌感染性疾病的诊断价值.国际检验医学杂志, 2014, 35(11):1485-1486.
15 李树林,顾畅.降钙素原、C-反应蛋白、白细胞计数和中性粒细胞百分比在肺部感染性疾病早期诊断中的应用.中国卫生检验杂志, 2016, 26(16):2343-2345.
16 陈丽萍,丛立,陈颖,等.血清降钙素原检测对革兰阴性菌或革兰阳性菌血流感染的诊断价值.中国呼吸与危重监护杂志, 2014,13(4):374-377.
17 Alis R, Fuster O, Rivera L, et al. Influence of age and gender on red blood cell distribution width. Clin Chem Lab Med, 2015, 53(2):e25-e28.
18 何思春,万绍恒,魏忠华,等.年龄和性别对红细胞分布宽度的影响.国际检验医学杂志, 2017, 38(1):121-123.
2 Quint JK, Millett ER, Joshi M, et al. Changes in the incidence,prevalence and mortality of bronchiectasis in the UK from 2004 to2013:a population-based cohort study. Eur Respir J, 2016, 47(1):186-193.
3 Kwak HJ, Moon JY, Choi YW, et al. High prevalence of bronchiectasis in adults:analysis of CT findings in a health screening program. Tohoku J Exp Med, 2010, 222(4):237-242.
4 Ellis HC, Cowman S, Fernandes M, et al. Predicting mortality in bronchiectasis using BSI and FRACED scores:a 19-year cohort study. Eur Respir J, 2016, 47(2):482-489.
5 Balta S, Demirkol S, Hatipoglu M, et al. Red cell distribution width is a predictor of mortality in patients with severe sepsis and septic shock. Am J Emerg Med, 2013, 31(6):989-990.
6 Salvagno GL, Sanchis-Gomar F, Picanza A, et al. Red blood cell distribution width:a simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci, 2015, 52(2):86-105.
7 张静,刘冬,许西琳,等.红细胞分布宽度与成人社区获得性肺炎严重程度的相关性分析.中国呼吸与危重监护杂志, 2018, 17(2):134-137.
8 葛均波,徐永健,梅长林,等.内科学.第8版.北京:人民卫生出版社, 2015, 37-40.
9 成人支气管扩张症诊治专家共识编写组.成人支气管扩张症诊治专家共识.中华结核和呼吸杂志, 2012, 35(7):485-492.
10 Chalmers JD, Goeminne P, Aliberti S, et al. The bronchiectasis severity index. An international derivation and validation study.Am J Respir Crit Care Med, 2014, 189(5):576-585.
11 陈荣昌,关伟杰,钟南山.支气管扩张症:需要更多的关注和研究.中华结核和呼吸杂志, 2017, 40(1):5-7.
12 盛伟利,张永祥,赵莹,等.支气管扩张严重度指数和FACED评分对支气管扩张症预后评估的比较.国际呼吸杂志, 2016,36(12):926-929.
13 中国医药教育协会感染疾病专业委员会.感染相关生物标志物临床意义解读专家共识.中华结核和呼吸杂志, 2017, 40(4):243-257.
14 杨德平,狄勇. PCT、WBC、CRP联合检测对早期细菌感染性疾病的诊断价值.国际检验医学杂志, 2014, 35(11):1485-1486.
15 李树林,顾畅.降钙素原、C-反应蛋白、白细胞计数和中性粒细胞百分比在肺部感染性疾病早期诊断中的应用.中国卫生检验杂志, 2016, 26(16):2343-2345.
16 陈丽萍,丛立,陈颖,等.血清降钙素原检测对革兰阴性菌或革兰阳性菌血流感染的诊断价值.中国呼吸与危重监护杂志, 2014,13(4):374-377.
17 Alis R, Fuster O, Rivera L, et al. Influence of age and gender on red blood cell distribution width. Clin Chem Lab Med, 2015, 53(2):e25-e28.
18 何思春,万绍恒,魏忠华,等.年龄和性别对红细胞分布宽度的影响.国际检验医学杂志, 2017, 38(1):121-123.