【摘要】 目的:探讨伤后第3天外周血红细胞分布宽度(RDW)与血小板计数的比值(RPR)在严重烧伤患者预后中的判断作用。方法:回顾性分析我院2008年1月—2014年12月收治的符合重度以上烧伤标准的成年患者325例,检测患者伤后第3天RDW和血小板计数。根据患者伤后第3天RPR中位数值将其分为高RPR(RPR≥0.124)组和低RPR(RPR<0.124)组,收集两组患者性别、年龄、烧伤严重程度、是否有吸入性损伤等指标的数据,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%(118例)和93.0%(146例),差异有统计学意义(P<0.05)。Cox回归分析提示伤后第3天RPR为预测烧伤死亡的独立危险因素(风险比:0.398,95%置信区间:0.200~0.794,P<0.01)。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,P<0.01)。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对严重烧伤患者预后的预测有临床意义。更多还原

【Abstract】 Objective:To investigate the prognostic value of the ratio the third day after injury of red blood cell distribution width(RBCDW) to blood platelet count(BPC) on prognosticating the patients with severe burn. Methods: Three hundred and twenty five adult patients with severe burn, admitted to the First Affiliated Hospital of Anhui Medical University from January 2008 to December 2014, were enrolled in present study. RBCDW and the BPC were detected the third day after burn. The patients were divided into two groups based on the median value of the ratio of RBCDW to BPC the third day after burn: high ratio group(the ratio ≥ 0.124) and low ratio group(the ratio < 0.124). The data of gender, age, burn severity and incidence of inhalation injury were collected and analyzed. The in-hospital survival rate in the severe burn patients was analyzed by Kaplan-Meier method, the results obtained were treated with Cox regression analysis, the receiver operator characteristic(ROC) curve was drawn for 61 died patients with severe burn, and the prognostic significance was evaluated of the Ratio of RBCDW to BPC for the patients with severe burn. Results: The in-hospital survival rates of high Ratio group and low Ratio group were 70.2%(118 cases) and 93%(146 cases), respectively, at the third day after burn, the difference was statistically significant(P<0.05). Cox regression analysis suggested that the third-day Ratio of RBCDW to BPC(HR: 0.398; 95%CI: 0.200~0.794) was an independent prognostic indicator for predicting burn death(P<0.01). ROC curve analysis in 61 died patients showed that the total area of the third-day Ratio of RBCDW to BPC was 0.776(95% CI: 0.706-0.846, P<0.01), and 0.192 was the cutoff value of the third-day Ratio(sensitivity: 62.3%, specifi city: 86.3%). Conclusions: The third-day Ratio of RBCDW to BPC can be used as an independent prognostic indicator for patients with severe burn更多还原