危重病患者血小板计数与急性生理与慢性健康评分Ⅱ分值及预后相关性分析  

Acute physiology and chronic health Ⅱ score, platelet count, and correlation between platelet count and prognosis among critically ill patients

作　　者：韩加裕[1] 张思泉[1] 李雷清[1] 

机构地区：[1]杭州市第六人民医院重症监护室,浙江310014

出　　处：《中国急救复苏与灾害医学杂志》2011年第3期225-226,229,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的评价ICU患者血小板计数与急性生理与慢性健康评分Ⅱ（APACHEⅡ）评分及预后的关系。方法收集中心ICU、外科重症病房（SICU）、急诊ICU（EICU）、神经重症病房830例（56．1±18．5）岁（3～98岁）患者入ICU后24h内APACHEⅡ分值及血小板计数。根据不同预后比较相应的APACHEⅡ分值及血小板计数。并按血小板水平分组分析其相应预后。结果预后良好组（n=711）的APACHEⅡ分值平均为7．8±4．5，显著低于预后不良组（n=119）（19．0±8．3，P=0．000）。预后不良组血小板值为（147．6±116．9）×10^9／L，显著低于预后良好组[（172．4±91．0）×10^9／L，P=0．031]。入住ICU时APACHEⅡ分值与血小板计数呈显著负相关（r=-0．113，P=0．001）。血小板减少组较不良预后率为25．0％，显著高于血小板非减少组不良（11．0％，P=-0．000）。入住ICU时APACHEⅡ分值与血小板计数呈显著负相关（r=-0．113，P=0．001）。结论血小板减少症提示病情重且不良预后可能性增加。Objective To evaluate the relationship between platelet count, acute physiology and chronic health （APACHE） Ⅱ score and prognosis among critically ill patients in ICU. Methods 830 critically ill patients admitted in central ICU, surgical ICU, emergency ICU, and neurological ICU underwent platelet count and APACHE Ⅱ score calculation. The correlation between the platelet count and the bad prognosis rate was analyzed. Results The APACHE Ⅱ score of the good prognosis group （n=711） was （7.8±4.5）, significantly lower than that of the bad prognosis group （n=119） [（19.0±8.30）, P=0.000]. The plate count of the bad prognosis group was （147.6±116.9）×10^9/L, significantly lower than that of the good prognosis group [（172.4±91.0）×10^9/L, P=0.031 ]. The bad prognosis rate of the low platelet group was 25.0%, significantly higher than that of the normal platelet group （11.0%, P=0.000）. The APACHE Ⅱ score at admission was significantly negatively correlated with the platelet count （r=-0.113, P=0.00）. Conclusion Thrombocytopenia indicateds poor prognosis in critically,ill patients.

关 键 词：血小板计数 APACHEⅡ评分 危重病 

分 类 号：R558.2[医药卫生—血液循环系统疾病]