| Objective:To analyze the relationship between the ratio of red blood cell distribution width to platelet count（RPR）and prognosis in patients with sepsis.Methods:Clinical data of 150 sepsis patients treated by the Critical Care Department of the First Affiliated Hospital of Bengbu Medical University from December 2018 to October 2020 were collected.They were divided into death and non-death groups according to their prognosis.The data with statistically significant differences between the two groups were incorporated into the COX risk regression model.According to the optimal critical value of RPR,the patients were divided into low RPR group and high RPR group,and the clinical data of the two groups were compared.The RPR,the red blood cell distribution width（RDW）,and the acute physiological and chronic health score（APACHEⅡ）were included in drawing the subject working curve（ROC curve）to analyze its predictive value on the prognosis of patients with sepsis.Results:In death group,procalcitonin[PCT（ng/ml）:6.20（2.32,14.60）vs 1.10（0.37,11.67）]、RDW（%:17.46（?）2.47 vs 15.17（?）1.85）、RPR（0.151（?）0.052 vs 0.099（?）0.042）、APACHEⅡscores（20.40（?）7.17 vs15.07（?）6.01）,the length of hospital stay（day:16.55±9.45 vs 12.10±8.54）was significantly higher than that in the non-death group（P<0.05）.The serum albumin[ALB（g/L）:29.71（?）8.23 vs 32.48（?）6.36]、and PLT（’109/L:130.21±52.58 vs 174.30±56.82）in death group were lower than those in non-death group（P<0.05）.In high RPR group,the proportion of bloodstream infection[case（%）:39（46.99）vs 18（26.87）],chronic renal insufficiency[case（%）:29（34.94）vs 13（19.40）]、continuous renal replacement therapy（CRRT）[（%）:46（55.42）vs 20（29.85）],APACHEⅡscore（22.05±6.33 vs 13.51±5.12）、the length of hospital stay（day:17.61±9.88 vs 11.18±7.19）、RDW（%:17.46±2.47 vs 15.17±1.85）、PCT[（ng/ml）6.20（2.32,14.60）vs 1.10（0.37,11.67）]、C-reactive protein[CRP（ng/ml）67.00（42.30,85.60）vs 51.00（27.30,69.96）]was significantly higher than that in low RPR group（P<0.05）.The PTL（（?）10~9/L:108.65±23.17 vs 197.05±51.27）and ALB[（g/L）:29.62±7.58 vs32.35±7.46]in the high RPR group were lower than those in the low RPR group,and the 28-day mortality in the high RPR group（34.94%）was higher than that in the low RPR group（13.43%）.COX regression analysis showed that high levels of RPR and RDW,high APACHEⅡscore and hypoalbuminemia were independent risk factors for death in patients with sepsis.The results of ROC curve showed that:The predictive value of RPR in predicting the prognosis of sepsis is better than that of RDW and APACHEII scores.Conclusion:RPR as a new inflammatory marker may be helpful to evaluate the prognosis of patients with sepsis. |
