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目的 探讨血浆红细胞分布宽度(RDW)与血清白蛋白(Alb)的比值(RAR)对免疫受损宿主肺炎(ICHP)患者预后的预测价值。方法 选取吉林省人民医院呼吸与危重症科就诊的ICHP患者，根据28d转归情况将患者分为生存组和死亡组，收集患者一般资料和实验室检查指标，通过单因素分析、多因素Logistic回归分析、受试者操作特征曲线和生存分析评估RAR与患者28d死亡率的关系。结果 死亡组年龄、病程、慢性肾病占比、慢性肺病占比、磨玻璃阴影、SOFA评分、APACHEⅡ评分、有呼吸窘迫综合征、RDW、RAR高于生存组，死亡组的氧合指数、Alb、红细胞计数低于生存组；多因素回归分析显示，RAR与ICHP患者28d死亡独立关联。RAR的死亡风险为AUC 0.770(95%CI 0.725～0.815),敏感度和特异度分别为0.806和0.587,截断值为4.232。结论 RAR对ICHP患者28d预后有较好的预测价值。
Abstract：Objective To investigate the predictive value of the ratio of plasma red blood cell distribution width(RDW) to serum albumin(Alb)(RAR) for the prognosis in patients with immunocompromised host pneumonia(ICHP).Methods ICHP patients who visited the Respiratory and Critical Care Department in Jilin Province People's Hospital were enrolled and categorized into survival and non-survival groups based on their 28-day outcomes.General information and experimental examination indicators of patients were used to evaluate the relationship between RAR and 28-day mortality rate through univariate analysis, multivariate logistic regression analysis, subject operating curve, and survival analysis.Results Compared with the survival group, the age, disease duration, proportion of chronic kidney disease, proportion of chronic lung disease, ground glass opacities, SOFA score, APACHE Ⅱ score, presence of respiratory distress syndrome, RDW,and RAR were higher in the death group.In contrast, the oxygenation index, Alb, Red blood cell count were lower.Multivariate regression analysis showed that RAR was independently associated with 28-day mortality in ICHP patients.The mortality risk of RAR was AUC 0.770(95% CI 0.725～0.815),with a sensitivity of 0.806 and a specificity of 0.587 at an optimal cutoff value of 4.232.Conclusion RAR has good predictive value for the 28-day prognosis of ICHP patients.
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基本信息:
DOI：10.16751/j.cnki.2095-4646.2025052107
中图分类号:R563.1
引用信息:
[1]金鑫,吴春风.细胞分布宽度与白蛋白比值对免疫受损宿主肺炎预后的预测价值[J].湖北科技学院学报(医学版),2026,40(01):49-53.DOI:10.16751/j.cnki.2095-4646.2025052107.
基金信息:
吉林省卫生健康科技能力提升项目(2021LC069)
2025-05-21
2025
2026-01-16
2026
2026-01-14
1
2025-11-28
2025-11-28
2025-11-28