老年重症脓毒症患者的凝血功能变化及与预后的关系  

The Relationship between Coagulation Function and Prognosis in the Elder Patients with Severe Sepsis

作　　者：高峰[1] 廖华[1] 高哲[1] 崔松 路桂杰 邢绣荣[4] 

机构地区：[1]河北省任丘市华北石油管理局总医院急诊科,河北062552 [2]河北省任丘市华北石油管理局总医院神经内科 [3]河北省任丘市华北石油管理局总医院井下医院检验科 [4]首都医科大学宣武医院急诊科

出　　处：《中国急救复苏与灾害医学杂志》2017年第11期1059-1061,共3页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：北京市教育委员会科技发展计划面上项目（KM201510025015）

摘　　要：目的探讨老年重症脓毒症患者的凝血功能变化及与预后的关系。方法选取2016年3月-2017年2月任丘市华北石油管理局总医院老年重症脓毒症患者149例，于入院第1天测定凝血功能、D二聚体和血小板水平，并计算APACHEⅡ评分。分析不同水平的APACHEⅡ评分与凝血功能、D二聚体及血小板水平的关系。并根据预后将患者分为存活组和死亡组，比较两组的凝血功能、D二聚体和血小板水平。结果死亡组血小板水平显著低于存活组，APACHEⅡ评分、PT、INR、AnT和D二聚体阳性率均显著高于存活组（P〈0．05）；随着APACHEⅡ评分分值升高，PT、INR、APTT、FIB、D二聚体阳性率及死亡率均明显升高（P〈0．05），血小板水平显著降低（P〈0．05）。结论老年重症脓毒症患者的凝血功能与预后显著相关，病情越重，凝血功能越差，血小板水平越低，死亡率越高。Objective To explore the relationship between coagulation function and APACHE Ⅱ score and prognosis in the eider patients with severe sepsis. Methods One hundred and forty-nine elder patients with severe sepsis were enrolled. The levels of coagulation function, D-dimer, platelet and the APACHE Ⅱ scores were evaluated at the 1st day in the hospital. The relationships between APACHE Ⅱ score and the coagulation function, D-dimer or platelet levels were analyzed. According to the prognosis, the patients were divided into two groups, the alive group and dead group. The coagulation function, D-dimer and platelet levels in two groups were compared. Results There were significant lower platelet levels in dead group than alive group, however, The levels of PT, INR, APTT, fibrinogen （FIB） and the positive ratio of D dimer, dead rate were significant increased alone with the elevation of APACHE Ⅱ score （P 〈0.05）, and the platelet levels decreased （P 〈0.05）. Conclusions In the elder patients with severe sepsis, the state of illness was more serious, the eoagulation function was more disordered, the platelet ievels were more lower and the dead rate was much more.

关 键 词：重症脓毒症 凝血功能 血小板水平 APACHE Ⅱ评分 预后 

分 类 号：R631.2[医药卫生—外科学]