SIRS患者血小板计数的动态变化及意义  

Dynamic changes of the platelet counts in patients with SIRS and their significance

作　　者：梁曼丽[1] 吴丽娟[2] 张冲 王强 尹培刚[2] 李广仁[2] 

机构地区：[1]北京市海淀区医院急诊科,北京100080 [2]中日友好医院ICU

出　　处：《急诊医学》1999年第4期246-248,共3页

摘　　要：目的 :根据全身炎性反应综合征 (SIRS)患者血小板 (PLT)计数早期及动态变化与多脏器功能失常综合征 (MODS)发生的关系 ,探讨PLT在MODS发生中的作用。方法 :连续测定符合SIRS标准的 84例患者PLT计数 ,按照入ICU2 4h内PLT计数分为A组 (PLT计数正常组 )、B组 (PLT计数减少组 ) ,观察早期PLT计数的改变与病情严重程度的关系及对MODS发生率、器官衰竭程度、病死率的影响。比较非MODS组、MODS存活组、MODS死亡组PLT计数动态变化的不同。结果 :A组与B组APACHEⅡ评分分别为 11 3± 6 5和 18 6± 4 2 ,P <0 0 0 1;MODS发生率分别为 2 6 %和 94 7% ,P <0 0 0 5 ;MODS严重程度评分分别为 8 7± 2 4和 13 8±6 5 ,P <0 0 0 1;病死率分别为 6 5 %和 44 7% ,P<0 0 0 5。动态观察PLT计数 ,非MODS组稳定在一个正常水平 ;MODS存活组第 1d下降明显 ,第 2～ 3d回升 ,至第 4d开始与非MODS组比较无明显差异 ,以后稳定在一个正常水平 ;MODS死亡组第 1d下降明显 ,第 2～ 3d轻度回升 ,第4d开始呈进行性下降趋势 ,整个病程均显著低于非MODS组。结论 :PLT在MODS的发生、发展中发挥着重要作用。早期PLT计数减少或病程中呈进行性下降 ,提示病情危重 ,MODS发生率高 。Objective:To explore the effects of platelet on MODS according to the relation between the dynamic changes of the PLT counts in patients with systemic inflammatory response syndrome(SIRS) and multiple organ dysfunction syndrome(MODS).Methods:The PLT counts of 84 patients who fulfil the standard of SIRS were measured continuously.These patients were divided into 2 guoups according to the PLT counts within 24h after entering ICU:group A(the group with normal PLT counts) and group B(the group with decreased PLT counts).The relation of levels of initial PLT counts with the severity of disease and the influence of levels of initial PLT counts to the incidence of MODS,the degree of organ dysfunction and the mortality rate were observed.The dynamic changes of PLT counts in the non MODS group,survival group and death group of MODS were compared.Results:The score of acute physiology and chronic health evalution (APACHE Ⅱ),the incidence of MODS,the score of the degree of organ dysfunction and the mortality rate were significantly higher in group B.The dynamic counts of PLT in non MODS group stabilized at a normal level,the PLT counts in the survival group of MODS decreased evidently on the first day and increased again on 2nd～3rd days and then stabilized at a normal level.For the death group of MODS,the PLT counts decreased obviously on the first day and somewhat incerased again on 2nd～3rd days and then started to decreased gradually.The PLT counts were significantly different between the non MODS group and the death group of MODS during the whole process.Conclusions:The PLT play an important role in the occurrence、development of MODS.The decrease of the PLT counts at initial stage and gradual drop during the process prompt that the state of illn

关 键 词：血小板计数 全身炎性反应 综合征 多器官衰竭 

分 类 号：R364.5[医药卫生—病理学] R446.111[医药卫生—基础医学]