危重病患者血小板计数变化的临床意义  

Clinical significance of the variance of platelets in patients of critical illness

作　　者：宋冬梅[1] 杨莉[1] 曹相原[2] 

机构地区：[1]宁夏银川市第一人民医院,宁夏银川750001 [2]宁夏医学院附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2007年第4期319-320,共2页Ningxia Medical Journal

摘　　要：目的研究血小板计数变化在危重病全身炎症反应综合征(SIRS)及脓毒症(Sepsis)监测中的意义。方法ICU内各种原因所致的SIRS及脓毒症患者,按28天生存率将患者分为死亡组和存活组。入院当天和第3、7、10天进行急性生理学和慢性健康状况Ⅱ评分(APACHEⅡ评分)及血小板检测。结果入ICU时存活组和死亡组APACHEⅡ评分明显增高,但无显著差异;治疗7天和10天后,存活组APACHEⅡ评分下降10分以下,而死亡组APACHEⅡ上升至20分以上(P<0.01)。血小板计数在入院时两组均降低,治疗3天后明显回升,但在治疗后7天和10天时死亡组血小板再度进行性下降,而存活组上升至正常范围(P<0.01)。结论血小板动态变化可敏感反映危重病SIRS及Sepsis患者的预后。Objective To investigate the clinical significance of the platelets variances in systemic inflammatory response syndrome （SIRS） or sepsis of critical illness. Methods Patients who suffered from severe SIRS and sepsis were enrolled in this study and divided into two groups, survivor group and non survivor group by 28 Day＇s suvival rate. Platelet counts and acute physiology and chronic health evaluaton Ⅱ （APACHE Ⅱ） score were peffomed immediately after hospitallization, 3, 7 and 10 days. Results APACHE Ⅱ score was much higher, but no difference in the two groups immediately after the hospitalization. However, it increased markedly in non survivor group and decreased dramatically in survivor group 7 days after therapy. There was significant difference between the two groups （ P 〈 0.01 ）. Platelets were slightly decreased in both groups immediately after the hospitalization. After three days of therapy, it increased to the normal range in the two groups. However, it progressively dropped in non survivor group 7days and 10 days later, and it was significantly different from survior group （ P 〈 0.001）. Conclusion Platelet variances is sensitively responsive to prognosis of SIRS and sepsis in critical patients.

关 键 词：血小板 全身炎症反应综合征 脓毒症 

分 类 号：R459.7[医药卫生—急诊医学]