摘要
目的:探究血乳酸、红细胞体积分布宽度(Red blood cell volume distribution width,RDW)、血小板体积分布宽度(Platelet volume distribution width,PDW)与急性上消化道出血患者病情及预后的关系。方法:回顾性分析2021年1月至2023年12月期间在我院就诊的66例急性上消化道出血患者的临床资料,根据其入院时病情严重情况分为严重组(失血量≥750 mL,n=41)和非严重组(失血量<750 mL,n=25)。比较入院时两组患者血乳酸、RDW、PDW等指标水平,采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析入院时血乳酸、RDW、PDW对急性上消化道出血患者的诊断效能。入院后30 d,根据快速序贯器官功能衰竭评估(Quick sequential organ failure assessment,qSOFA)评分将患者分为预后不良组(qSOFA≥1分)和预后良好组(qSOFA<1分)两亚组,比较两亚组患者入院后30 d血乳酸、RDW、PDW水平和qSOFA评分的关系。结果:入院时,严重组的血乳酸、RDW、PDW水平显著高于非严重组(P<0.05),血乳酸、RDW、PDW水平三者单一指标检测的ROC曲线下面积(Area under the ROC curve,AUC)值分别是0.861、0.769、0.763,差异具有统计学意义(P<0.05)。预后不良组入院时的血乳酸、RDW、PDW水平显著高于预后良好组(P<0.05),Pearson相关系数分析显示,血乳酸、RDW、PDW水平和qSOFA评分具有相关性。结论:血乳酸、RDW、PDW与急性上消化道出血患者预后密切相关,可以提供重要的诊断和治疗参考,帮助改善患者的预后和治疗效果。
Objective:To explore the relationship between blood lactate,red blood cell volume distribution width(RDW)and platelet volume distribution width(PDW)and disease condition and prognosis in patients with acute upper gastrointestinal bleeding(AUGIB).Methods:A retrospective analysis was conducted on the clinical data of 66 patients with AUGIB in the hospital from January 2021 to December 2023.Based on the disease severity at admission,they were divided into severe group(blood loss≥750 mL,n=41)and non-severe group(blood loss<750 mL,n=25).The levels of blood lactate,RDW,PDW and other indicators were compared between groups of patients at admission,and receiver operating characteristic(ROC)curve was applied to analyze the diagnostic efficiency of blood lactate,RDW,and PDW at admission on patients with AUGIB.At 30 days after admission,patients were divided into two subgroups based on quick sequential organ failure assessment(qSOFA)score:poor prognosis group(qSOFA≥1 point)and good prognosis group(qSOFA<1 point).The relationship of blood lactate,RDW and PDW levels with qSOFA score at 30 days after admission was compared between the two subgroups.Results:At admission,the levels of blood lactate,RDW,and PDW in the severe group were significantly higher than those in the non-severe group(P<0.05).The areas under the ROC curves(AUCs)of blood lactate,RDW,and PDW were 0.861,0.769,and 0.763 respectively(P<0.05).The levels of blood lactate,RDW,and PDW at admission were significantly higher in the poor prognosis group than those in the good prognosis group(P<0.05).Pearson correlation coefficient analysis showed a correlation between blood lactate,RDW and PDW levels and qSOFA score.Conclusion:Blood lactate,RDW,and PDW are closely related to the prognosis of patients with acute upper gastrointestinal bleeding,and can provide important diagnostic and treatment references,to help improve the prognosis and treatment effect of patients.
作者
曾燕娇
邝梦真
朱建娣
Zeng Yan-jiao;Kuang Meng-zhen;Zhu Jian-di(The People's Hospital of Xunwu,Ganzhou 342200,Jiangxi,China)
关键词
血乳酸
RDW
PDW
急性上消化道出血
病情
预后
Blood lactate
RDW
PDW
Acute upper gastrointestinal bleeding
Disease condition
Prognosis
作者简介
曾燕娇,女,主管技师,主要从事输血工作,Email:13763982684@163.com。
