红细胞分布宽度与血小板的比值对严重烧伤患者预后的判断价值

发布时间：2018-01-12 15:20

  本文关键词：红细胞分布宽度与血小板的比值对严重烧伤患者预后的判断价值　出处：《安徽医科大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 烧伤 预后 红细胞分布宽度 血小板计数

【摘要】：目的:严重烧伤作为一种死亡率高,危险性大的急性创伤性疾病,如何对烧伤的严重程度进行评估,选择最佳的烧伤危险预测生物标志物一直都是烧伤治疗工作者的关注焦点。红细胞分布宽度(RDW)与血小板的比值(RDW-to-platelet ratio,RPR)作为一种新型血液学指标诊断模型被应用于慢性肝炎患者肝硬化肝纤维化的发生,急性重症胰腺炎以及心肌梗死患者等多种疾病的死亡风险评估,然而RPR在判断严重烧伤患者病情严重程度以及评估预后的价值国内外尚未有明确研究。本研究主要探讨伤后第3天外周血红细胞分布宽度(red blood cell distribution width,RDW)与血小板计数的比值(RDW-to-platelet ratio,RPR)在严重烧伤患者预后中的判断价值。方法:收集安徽医科大学第一附属医院烧伤外科2009年1月至2014年12月收治重度及以上烧伤患者325例,收集严重烧伤患者的基本资料和伤后第三天的血常规肝肾功能等实验室指标。根据患者伤后第3天RPR中位数值将其分为RPR≥0.124和RPR0.124的高低两组,比较两组患者性别、年龄、住院时间、结局、烧伤严重程度、是否有吸入性损伤等。对相应数据行x2检验,采用Kaplan-Meier法分析严重烧伤住院期间生存率并将结果带入Cox回归分析,同时绘制61例死亡患者ROC受试者工作曲线,探讨伤后第3天RPR对严重烧伤患者预后的判断作用。结果:伤后第3天高RPR组和低RPR组在严重烧伤住院期间生存率分别为70.2%和93%,差异有统计学意义(P0.01)。Cox回归分析提示伤后第3天RPR(HR:0.398;95%CI:0.200-0.794)为预测烧伤死亡的独立危险因素(P0.01)。对61例死亡患者ROC曲线分析提示伤后第3天RPR值ROC曲线下总面积为0.776(95%置信区间为0.706-0.846,P0.01)。其中伤后第3天RPR的最佳阈值为0.192时敏感性62.3%,特异性86.3%。结论:伤后第3天RPR与严重烧伤患者的病情严重程度和预后密切相关,对严重烧伤不良预后的预测有临床意义。
[Abstract]:Objective: as a kind of acute traumatic disease with high mortality and high risk, how to evaluate the severity of severe burn. The selection of the best biomarker for predicting burn risk has always been the focus of attention of burn therapists. RDW / Platelet ratio (RDW). RDW-to-platelet ratio. As a new hematological diagnostic model, RPR has been used to assess the risk of death in patients with chronic hepatitis such as liver fibrosis, severe acute pancreatitis and myocardial infarction. However, the value of RPR in judging the severity of severe burns and evaluating the prognosis has not been clearly studied at home and abroad. Red blood cell distribution width. The ratio of RDW) to platelet count was determined by RDW-to-platelet ratio. RPR). Methods: from January 2009 to December 2014, a total of 325 patients with severe burn or above were admitted to the Department of Burn surgery, first affiliated Hospital of Anhui Medical University. The basic data of severe burn patients and the laboratory indexes of blood routine liver and kidney function on the third day after injury were collected. According to the median value of RPR on the 3rd day after injury, the patients were divided into RPR 鈮，

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