探讨血小板计数及凝血四项指标对脓毒症患者合并DIC的临床预测意义  

Discussion on the clinical significance of platelet count and four items of blood coagulation in the prediction of sepsis with DIC

作　　者：廖梅嫣 曾汇霞 吴海宾[1] 李朝辉[1] 梁燕媚[1] LIAO Mei-yan;ZENG Hui-xia;WU Hai-bin(Zhaoqing Second People's Hospital,Zhaoqing 526060,China)

机构地区：[1]广东省肇庆市第二人民医院ICU

出　　处：《中国实用医药》2020年第2期23-25,共3页China Practical Medicine

摘　　要：目的探讨血小板计数及凝血四项指标对脓毒症合并弥散性血管内凝血(DIC)患者的临床意义。方法选取100例重症加强护理病房(ICU)收治并被诊断为脓毒症的患者,根据是否合并DIC分为实验组(22例,合并DIC)和对照组(78例,不合并DIC)。测定两组患者确诊为脓毒症24 h内的血小板计数及凝血四项指标,并进行组间比较。结果实验组患者的凝血酶原时间、凝血酶时间、活化部分凝血活酶时间、纤维蛋白原、血小板计数分别为(19.16±3.58)s、(18.18±3.19)s、(40.63±8.60)s、(1.79±0.93)g/L、(199.00±80.80)×10~9/L,对照组患者的凝血酶原时间、凝血酶时间、活化部分凝血活酶时间、纤维蛋白原、血小板计数分别为(15.26±3.00)s、(17.71±2.54)s、(36.51±7.67)s、(1.70±0.89)g/L、(240.50±76.43)×10~9/L;实验组患者的凝血酶原时间、活化部分凝血活酶时间均长于对照组,血小板计数低于对照组,差异均具有统计学意义(P<0.05);两组患者的凝血酶时间和纤维蛋白原水平比较差异均无统计学意义(P>0.05)。结论在脓毒症致DIC的发展过程中,血小板计数及凝血四项指标可作为脓毒症合并DIC的预测指标,提示在确诊为脓毒症24 h内低凝状态越明显的患者越容易出现DIC。Objective To discuss the clinical significance of platelet count and four items of blood coagulation in the prediction of sepsis with disseminated intravascular coagulation(DIC). Methods A total of 100 sepsis patients in intensive care unit(ICU) were divided into experimental group(22 cases, with DIC) and control group(78 cases, without DIC) according to whether DIC was combined or not. Platelet count and four items of blood coagulation were measured within 24 h of the diagnosis of sepsis in the two groups, and compared between groups. Results The prothrombin time, thrombin time, activated partial thromboplastin time, fibrinogen, platelet count were(19.16±3.58) s,(18.18±3.19) s,(40.63±8.60) s,(1.79±0.93) g/L and(199.00±80.80)×10~9/L respectively in the experimental group, which were(15.26±3.00) s,(17.71±2.54) s,(36.51±7.67) s,(1.70± 0.89) g/L and(240.50±76.43)×10~9/L in the control group. The prothrombin time and activated partial thromboplastin time in the experimental group was longer than those in the control group, and platelet count was lower than that in the control group, and their difference was statistically significant(P<0.05). There was no statistically significant difference in thrombin time and fibrinogen level between the two groups(P>0.05). Conclusion In the development of DIC caused by sepsis, platelet count and four items of blood coagulation can be used as predictors of sepsis combined with DIC, suggesting that patients with hypocoagulation more obvious within 24 h of diagnosis of sepsis are more likely to develop DIC.

关 键 词：凝血 纤溶 脓毒症 弥散性血管内凝血 

分 类 号：R459.7[医药卫生—急诊医学]