红细胞分布宽度对儿童脓毒症的预后价值的Meta分析

Meta-Analysis of the Prognostic Value of Red Blood Cell Width in Children with Sepsis

摘要: 目的：探讨红细胞分布宽度(RDW)与脓毒症患儿的预后关系。方法：通过检索PubMed、Embase、Cochrane、Web of Science、万方和CNKI等数据库，检索时间截止至2024年8月，系统收集并分析了RDW与儿童脓毒症相互作用的研究资料。主要结局指标包括儿童脓毒症休克的发生率和儿童脓毒症的死亡率，使用标准均值差(SMD)包含相应的95%置信区间(CI)进行评估。根据敏感性分析和亚组分析来分析结果的稳定性及潜在的异质性来源。结果：文章共纳入13项队列研究，包括2605例患者。分析结果显示，脓毒症休克的RDW高于非脓毒症休克患儿(SMD = 1.26, 95% CI (0.95, 1.57), p < 0.00001)。高RDW组的PCIS评分低于正常RDW组PCIS评分(SMD = −0.83, 95% CI (−1.13, −0.53), p < 0.00001)。脓毒症死亡儿童的RDW高于脓毒症存活的儿童(SMD = 2.77, 95% CI (1.61, 3.93), p < 0.00001)。结论：RDW与儿童脓毒症的预后存在显著相关性，可作为临床预测预后的指标。然而，鉴于本研究的局限性，仍需更多前瞻性研究进一步验证RDW与儿童脓毒症预后的关系。

Abstract: Objective: To investigate the relationship between red blood cell distribution width (RDW) and the prognosis of children with sepsis. Methods: PubMed, Embase, Cochrane, Web of Science, Wanfang, and CNKI databases were searched to August 2024, and the data on the interaction between RDW and childhood sepsis were systematically collected and analyzed. Primary outcomes included incidence of septic shock in children and mortality from sepsis in children, assessed using standard mean differences (SMDs) with corresponding 95% confidence intervals (CIs). Sensitivity analysis and subgroup analyses were used to analyze the stability of results and potential sources of heterogeneity. Results: A total of 13 cohort studies involving 2605 patients were included in this review. The results of the analysis showed that the RDW of septic shock was higher than that of non-septic shock children (SMD = 1.26, 95% CI (0.95, 1.57), p < 0.00001). The PCIS score in the high RDW group was lower than that in the normal RDW group (SMD = −0.83, 95% CI (−1.13, −0.53), p < 0.00001). The RDW of children who died of sepsis was higher than that of children who survived sepsis (SMD = 2.77, 95% CI (1.61, 3.93), p < 0.00001). Conclusion: RDW is significantly correlated with the prognosis of sepsis in children, and can be used as a clinical prognosis indicator. However, given the limitations of this study, more prospective studies are needed to further validate the relationship between RDW and the prognosis of sepsis in children.