脓毒症患者中红细胞分布宽度与血乳酸关系的研究

doi:10.3969/j.issn.1002-1949.2018.10.009

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摘要目的探讨红细胞分布宽度（RDW）与脓毒症患者的组织灌注的关系。方法回顾性收集2013-05~2015-02期间北京协和医院重症医学科（ICU）脓毒症患者的临床资料，其中包括基线、血流动力学和实验室资料。根据RDW是否>15%分为RDW升高组（RDW>15%）和RDW正常组（RDW ≤15%）。结果共收集300例脓毒症患者纳入研究，其中RDW升高组148例，RDW正常组152例。与RDW正常组相比，RDW升高组患者的入室及入室24 h后血乳酸（Lac）和Lac＞2.0 mmol/L的比例相对较高［2.1（1.1~3.7） mmol/L vs. 2.9（1.2~5.4）mmol/L，P=0.019；42.7%（65/152） vs. 56.8%（83/148），P=0.021；1.3（0.9~2.4）mmol/L vs. 1.6（1.1~3.5）mmol/L，P=0.039； 24.5%（36/147） vs. 35.9%（55/153）, P=0.031］。RDW与入室及入室24 h后血Lac也具有弱相关性（r=0.154，P=0.008；r=0.124，P=0.031）。但在入室及入室24 h后血Lac的多元线性回归分析中发现，RDW并不是血Lac的影响因素。结论 RDW>15%的脓毒症患者比正常RDW脓毒症患者的入室及入室24 h的血Lac值要高，但RDW并不是影响血Lac的因素。

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	姚波
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关键词 ：脓毒症, 红细胞分布宽度（RDW）, 乳酸（Lac）, 组织灌注, 微循环

通讯作者: 刘大为（1960-），男，硕士，教授，主任医师，E-mail:dwliu98@163.com。

作者简介: 姚波(1987-)，男，博士，住院医师，E-mail:icuyaobo@126.com。

引用本文:

姚波，刘大为，柴文昭，王小亭，张宏民. 脓毒症患者中红细胞分布宽度与血乳酸关系的研究[J]. 中国急救医学, 2018, 38(10): 874-878.
Yao Bo, Liu Da-wei, Chai Wen-zhao, Wang Xiao-ting, Zhang Hong-min. The relationship between red blood cell distribution width and blood lactate value in sepsis patients. Chinese Journal of Critical Care Medicine, 2018, 38(10): 874-878.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2018.10.009 或 http://www.cnemergency.org.cn/CN/Y2018/V38/I10/874

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