动态监测血小板参数对临床治疗脓毒症相关性血小板减少症的价值  

The Value of Monitoring Platelet Parameters for the Treatment in Patients with Thrombocytopenia Induced by Sepsis

作　　者：林幼萍[1] 陈怿[1] 陈玉兰[1] 冯茹[2] 

机构地区：[1]广东省东莞市第五人民医院(暨南大学医学院附属东莞医院)重症医学科,523900 [2]南方医科大学南方医院血液科

出　　处：《岭南急诊医学杂志》2016年第1期16-18,共3页Lingnan Journal of Emergency Medicine

基　　金：广东省东莞市社会科技发展项目(2014108101012)

摘　　要：目的:观察脓毒症相关性血小板减少症患者血小板参数的动态变化,探讨血小板参数与血小板计数(PC)之间的关系及其临床价值。方法:动态观察40例脓毒症相关性血小板减少症患者的血小板相关参数—平均血小板体积(MPV)、血小板分布宽度(PDW)、大血小板比率(P-LCR)与PC的变化,并对所有患者进行急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分,将各参数MPV、PDW、P-LCR与APACHEⅡ评分、PC进行统计学分析。结果:MPV、PDW和P-LCR值与APACHEⅡ评分之间呈正相关(Pearson系数分别为0.455,0.468,0.535,P<0.01);MPV、PDW和P-LCR值与PC之间呈负相关(Pearson系数分别为-0.533,-0.550,-0.638,P<0.01);PC于观察的第4 d降至最低值,第7 d开始恢复(P<0.05),而MPV、PDW和P-LCR在观察的第4 d升至最高值,但在第6 d开始下降(P<0.05),MPV、PDW和P-LCR变化均早于PC的变化。结论:动态监测MPV、PDW、P-LCR对脓毒症相关性血小板减少症患者PC恢复具有良好的预判价值,对脓毒症相关性血小板减少症的病情观察与评估具有重要意义。Objective： To investigate the correlation between platelet parameters and platelet count（PC） in patients with thrombocytopenia induced by sepsis. Methods： Forty patients with thrombocytopenia induced by sepsis were involved in this study. The platelet parameters--mean platelet volume（MPV）, platelet distribution width（PDW）, platelet-large cell ratio（P-LCR） and PC were detected and acute physiology and chronic health evaluationⅡ（APACHEⅡ） scores were recorded in everyday. All the data between platelet parameters with PC and APACHEⅡscores were statistically analyzed. Results： The correlation between MPV, PDW, P-LCR and APACHE Ⅱ score was positive. The Pearson correlation coefficient was 0.455, 0.468, 0.535, P〈0.01.The correlation between MPV, PDW,P-LCR and PC was negative. The Pearson correlation coefficient was-0.533,-0.550,-0.638, P〈0.01.The value of PC was observed to be a minimum in the 4th day and recovered in the 7th day after the beginning of study（P〈0.05）.Otherwise, the level of MPV, PDW, P-LCR reached a peak value in the 4th day and began to decrease in the6 th day（P〈0.05）. The change of MPV, PDW and P-LCR were earlier than that in PC. Conclusions： The dynamical change of MPV, PDW and P-LCR were indicative to the recovery of PC, and these parameters were helpful to observe and evaluate the severity and prognosis in patients with thrombocytopenia induced by sepsis.

关 键 词：脓毒症 平均血小板体积 血小板分布宽度 大血小板比率 血小板减少 

分 类 号：R459.7[医药卫生—急诊医学] R558.2[医药卫生—治疗学]