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目的探讨外周血有核红细胞(NRBC)阳性在对危重患者预后评估中的临床价值。方法收集2016年7月-12月外周血NRBC阳性的患者和同时段NRBC阴性患者外周血标本。并检测NRBC阳性患者的NRBC浓度及其他炎症指标。结果 NRBC阳性患者的病死率为30.3%(20/66),NRBC阴性患者的病死率为1.1%(35/3 297),差异有统计学意义(P<0.01),且在一定范围内,浓度越高,预后越差(P<0.05)。ICU和消化科的患者外周血NRBC阳性与阴性组的病死率差异有统计学意义(P<0.05),神经系统、呼吸系统及消化系统疾病患者的NRBC阳性组与阴性组比较,病死率差异有统计学意义(P<0.05)。此外,在NRBC阳性患者中CRP和D-D浓度越高,预后越差(P<0.05)。结论NRBC对危重患者预后评估有一定临床价值,尤其对脑部疾病和呼吸系统疾病更加适用,结合CRP和D-D等炎症指标意义更佳。
Objective To investigate the clinical value of the positive of peripheral blood nucleated red blood cells (NRBCs) in the evaluation of prognosis of critically ill patients. Methods Peripheral blood samples from NRBC-positive patients and NRBC-negative patients from July 2016 to December 2016 were collected. NRBC concentrations in NRBC positive patients and other inflammatory markers were also tested. Results The case fatality rate was 30.3% (20/66) in NRBC positive patients and 1.1% (35/3 297) in NRBC negative patients, the difference was statistically significant (P <0.01). In a certain range, The higher the prognosis, the poorer (P <0.05). There was significant difference in the mortality of NRBC positive and negative patients in the ICU and Gastroenterology patients (P <0.05). The differences in mortality between the NRBC positive patients and the negative patients in the nervous system, respiratory system and digestive system diseases were Statistical significance (P <0.05). In addition, the higher the CRP and D-D concentrations in NRBC-positive patients, the worse the prognosis (P <0.05). Conclusion NRBC has some clinical value in the prognosis assessment of critically ill patients, especially for brain diseases and respiratory diseases. The combination of CRP, D-D and other indicators of inflammation is more meaningful.