脓毒症患者血小板功能变化与免疫指标的相关性研究  

Correlation study between platelet function and immune parameters in septic patients

作　　者：梁继芳 武卫东 杨晓静 王秀哲 武文静 石海鹏 Liang Jifang;Wu Weidong;Yang Xiaojing;Wang Xiuzhe;Wu Wenjing;Shi Haipeng(Department of Intensive Care Unit,Shanxi Dayi Hospital,Taiyuan 030032,China)

机构地区：[1]山西省太原市山西大医院重症医学科,030032

出　　处：《中国综合临床》2019年第1期45-48,共4页Clinical Medicine of China

基　　金：山西省科技厅社会发展方面重点研发计划项目(201603D321065).

摘　　要：目的研究脓毒症患者血小板功能与免疫指标的相关性。方法回顾性分析山西大医院重症医学科2016年7月1日至2017年10月31日收治的101例脓毒症患者的血小板功能及免疫指标,根据其有无休克分为休克组(34例)与无休克组(67例),另选取同期健康体检者50名为对照组。比较血小板功能与免疫指标变化的关系。结果(1)脓毒性休克组血栓弹力图最大血块强度值降低的发生率高于无休克组,且差异有统计学意义[65.67%(44/67)与23.53%( 8/34),χ^2=41.28,P<0.05];(2)脓毒性休克组CD4^+T淋巴细胞、C3均较无休克组下降[(47.28±7.78)%与54.93%±11.26,t=3.554,P<0.05;(0.42±0.23) g/L与( 0.75±0.19) g/L,t=-3.057,P<0.05],CD4^+/CD8^+T淋巴细胞比值较无休克组增大(2.68±0.18与2.45±0.07,t=7.18,P<0.001)。(3)血栓弹力图最大血块强度值与CD4^+T淋巴细胞百分比、CD4^+/CD8^+T淋巴细胞比值、补体C3、急性生理学与慢性健康状况评分系统Ⅱ评分、序贯器官衰竭评分的变化具有相关性(r值分别为0.617,0.411,0.563、-0.631、-0.547,P<0.01或P<0.05)。结论脓毒症患者存在血小板功能低下,其与免疫指标的变化具有相关性。Objective To explore the correlation between platelet function and immunity index in patients with sepsis.Methods The platelet function and immune indexes of one hundred and one patients with sepsis treated in Shanxi Dayi Hospital from July 1st, 2016 to October 31st, 2017 were analyzed retrospectively.According to their shock, they were divided into shock group (34 cases) and non shock group (67 cases). Another 50 healthy people in the same period in our hospital were selected as control group.The relationship between platelet function and immune indexes was compared.Results (1)the incidence of maximum blood block intensity decreased in the thrombus map of the septic shock group was higher than that in the non shock group, and the difference was statistically significant (65.67%(44/67) vs.23.53%(8/34), χ^2=41.28, P<0.05);(2) the CD4^+ T lymphocyte and C3 in the septic shock group were all lower than those in the non shock group ((47.28%±7.78) vs.(54.93%±11.26), t=3.554, P<0.05;(0.42±0.23) g/L vs.(0.75±0.19) g/L, t=-3.057, P<0.05), the ratio of CD4^+ /CD8^+ T lymphocyte was higher than that in non shock group ((2.68±0.18) vs.(2.45±0.07), t=7.18, P<0.001)). (3) the maximum intensity of blood clots was correlated with the percentage of CD4^+ T lymphocyte, CD4^+ /CD8^+ T lymphocyte ratio, complement C3, acute physiology and chronic health status score system II score, and sequential organ failure score (r=0.617, 0.411, 0.563, -0.631, -0.547, P<0.01, or P<0.05).Conclusion Thrombocytopenia is present in septic patients, which is correlated with changes in immune indices.

关 键 词：脓毒症 脓毒性休克 血栓弹力图 免疫指标 

分 类 号：R459.7[医药卫生—急诊医学]