Abstract：Objective: To explore the value of red blood cell distribution width (RDW), D-dimer (D-D), inflammatory factors, and transthoracic lung ultrasound in evaluating the prognosis of sepsis patients.Methods: A retrospective study was conducted on 98 sepsis patients treated in our hospital from January 2020 to October 2023, including 51 patients with simple sepsis and 47 patients with septic shock. There were 26 deceased patients and 72 surviving patients. Clinical data, RDW, D-D, inflammatory factors, and transthoracic lung ultrasound differences were compared among patients with and without shock, and with different prognoses. Factors influencing patient prognosis were analyzed.Results: Sepsis shock patients had RDW, D-D, interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), transthoracic lung ultrasound B-line fusion >2 zones ratio, and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores of 16.68 (14.12, 19.55)%, 3.22 (2.15, 7.78) mg/L, (410.03±102.21) pg/L, (32.21±11.15) mg/L, (503.74±98.87) ng/mL, 70.21%, and (18.84±1.15) points, respectively, which were higher than those of simple sepsis patients (P<0.05). The age, proportion of septic shock, RDW, D-D, IL-6, CRP, TNF-alpha, transthoracic lung ultrasound B-line fusion >2 zones ratio, and APACHE Ⅱ scores of deceased patients were (65.51±8.22) years, 76.92%, 18.87 (15.21, 22.10)%, 3.90 (2.65, 8.10) mg/L, (425.59±98.21) pg/L, (31.14±9.98) mg/L, (522.25±100.18) ng/ml, 88.46%, and (19.11±1.43) points, respectively, which were higher than those of surviving patients (P<0.05). Logistic regression analysis showed that RDW, D-D, IL-6, CRP, TNF-alpha, transthoracic lung ultrasound B-line fusion >2 zones ratio, and APACHE Ⅱ scores were influencing factors for patient mortality (P<0.05). The area under the ROC curve for predicting mortality in sepsis patients using the Logistic model was 0.842 (95%CI: 0.757-0.927), with sensitivity and specificity of 76.00% and 78.10%, respectively.Conclusion: RDW, D-D, IL-6, CRP, TNF-alpha, and transthoracic lung ultrasound B-line fusion are related to whether sepsis patients develop shock and their prognosis, and have certain application value in predicting patient prognosis.
吴高飞, 吴若林, 陈园园, 程高翔. RDW D-二聚体 炎性因子及经胸肺超声评估脓毒症患者预后的价值[J]. 河北医学, 2024, 30(6): 918-923.
WU Gaofei, et al. The Value of RDW D-dimer Inflammatory Factors and Transthoracic Pulmonary Ultrasound in Evaluating the Prognosis of Sepsis Patients. HeBei Med, 2024, 30(6): 918-923.
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2024, Vol. 30 
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