脓毒症患者血栓前体蛋白测定的临床价值探讨  

Clinical Value of Plasma Thrombus Precursor Protein(TPP) Concentration in Patients with Sepsis

作　　者：齐云晓[1] 刘敏涓[1] 叶絮[1] 冯莹[1] 

机构地区：[1]广州医学院第二附属医院血液科,广州510260

出　　处：《血栓与止血学》2008年第3期105-107,共3页Chinese Journal of Thrombosis and Hemostasis

基　　金：广东省科技划项目基金资助(编号:2005B30601008)

摘　　要：目的探讨血栓前体蛋白（TPP）浓度检测在严重脓毒症中的临床价值。方法将本院2007年2月～2007年11月收治的17例严重脓毒症患者的生存组和死亡组，分别测定其血栓前体蛋白浓度、活化部分凝血活酶时间（aPTT）、凝血酶原时间（PT）、纤维蛋白原（Fbg）、D二聚体（D-D）含量，并将其与14例一般感染者，9例正常对照组进行比较。结果①严重脓毒症组TPP浓度、D-D含量增高的阳性率明显高于一般感染组和正常对照组（P均〈0．01），而3组间aPTT、PT、Fbg差异均无统计学意义（P均〉0．05）；②严重脓毒症组死亡患者的TPP浓度与生存者相比差异有统计学意义（P〈0．05）。结论TPP可作为严重脓毒症早期高凝状态的诊断指标，并可帮助临床医师判断脓毒症的预后。Objective To investigate the clinical significance of the different plasma thrombus precursor protein （TPP） in patients with sepsis . Methods 17 cases of sepsis diagnosed according to 1992 American breast doctor institute diagnostic standards were selected for this study. All the patients were divided into two groups survival （n=11） and death （n=6）. Activated partial thromboplastm time （aPTT）, prothrombin time （PT） ,fibrin（Fbg） and D-D （D-D） were measured in 17 sepsis group. Determined the plasma TPP using Enzyme linked immunosorbent assay. All the values were compared with those obtained from 14 patients with ordinary infection and 9 healthy normal controls. Results ①Comparing with the ordinary infection and normal control group, the TPP concentration and positive rate of D-D elevated obviously in serious sepsis group （P〈0.01）. But there were no differences in levels of aPTT, PT and Fbg among those three groups （P〉0.05）.② The concentration of TPP were significantly higher in the patient group that died compared to the one that survived （P〈0.05）. But the levels of aPTT, PT and Fbg had no difference between the two groups （P〉0.05）. Conclusion There are dysfunction of coagulation in the patients with sepsis. The concentration of TPP can be looked as a diagnostic and prognostic index for early hypercoagulabale state and outcome of sepsis.

关 键 词：脓毒症 血栓前体蛋白 D二聚体 

分 类 号：R631.2[医药卫生—外科学]