最大血块强度值对脓血症患者血小板计数变化的预测价值  

Predictive value of maximum blood clot intensity value for platelet count changes in patients with sepsis

作　　者：慕容锐 高明霞[1] MURONG Rui;GAO Mingxia(Department of Intensive Care Medicine,the First People's Hospital of Zhaoqing in Guangdong Province,Zhaoqing 526000,China)

机构地区：[1]广东省肇庆市第一人民医院重症医学科,广东肇庆526000

出　　处：《中国现代医生》2022年第16期1-4,共4页China Modern Doctor

摘　　要：目的 探讨最大血块强度值对脓血症患者血小板计数变化的预测价值。方法 回顾性分析2018年6月~2020年12月广东省肇庆市第一人民医院重症医学科收治的脓血症患者90例的临床资料。按照血栓弹力图最大血块强度(MA)值分为两组,每组各45例。比较不同MA值(即MA值正常组和MA值降低组)患者SOFA评分、APACHEⅡ评分及血小板计数变化,针对不同MA值患者预后及生存情况绘制生存分析曲线,并针对血栓弹力图MA值与患者血小板变化进行相关性分析,绘制MA值预测血小板降低的ROC曲线,计算AUC面积。结果 MA值正常组其SOFA评分为(10.21±0.81)分,低于MA值降低组的(20.10±1.10)分(P<0.05),APACHEⅡ评分为(12.42±1.61)分,低于MA值降低组的(22.11±2.60)分(P<0.05),血小板计数为(117.81±8.52)×10^(9)/L高于MA值降低组的(88.30±4.71)×10^(9)/L (P<0.05),MA值正常组病情好转后转入普通病房比例显著高于MA值降低组(P<0.05),同时MA值正常组生存时间显著长于MA值降低组(P<0.05),血栓弹力图MA值与患者血小板变化呈正相关(r=0.8268,P<0.001),MA值预测血小板降低的ROC曲线下AUC面积为0.8339,具有较高的预测价值。结论脓血症患者血栓弹力图中最大血块强度值,对预测患者预后及生存时间有一定价值,其变化与血小板计数及功能变化呈正相关,能有效预测血小板的变化情况。Objective To investigate the predictive value of maximum blood clot intensity value for platelet count changes in patients with sepsis. Methods The clinical data of 90 patients with sepsis admitted to the Department of Intensive Care Medicine of the First People’s Hospital of Zhaoqing in Guangdong Province from June 2018 to December 2020 were retrospectively analyzed. They were divided into two groups according to the maximum clot strength(MA) value of thromboelastography, with 45 cases in each group. Changes in SOFA score, APACHE Ⅱ score and platelet count were compared in patients with different MA values(normal MA group and decreased MA group). Survival analysis curve was drawn for the prognosis and survival of patients with different MA values. Correlation analysis was performed between thromboelastography MA value and platelet changes. ROC curve was drawn for MA value to predict thrombocytopenia and AUC area was calculated. Results The SOFA score of the normal MA group was(10.21±0.81) points, which was lower than that([20.10±1.10] points) of the decreased MA group(P<0.05). The APACHEⅡscore of the normal MA group was(12.42±1.61) points, which was lower than that([22.11±2.60] points) of the decreased MA group(P<0.05). The platelet count of the normal MA group was(117.81±8.52)×10^(9)/L, which was higher than that [(88.30±4.71)×10^(9)/L] of the decreased MA group(P<0.05). The proportion of patients transferred to the general ward after condition improvement in the normal MA group was significantly higher than that of the decreased MA group(P<0.05), and the survival time of the normal MA group was significantly longer than that of the decreased MA group(P<0.05). There was a positive correlation between thromboelastography MA values and platelet changes in patients(r =0.8268, P <0.001). The AUC area under the ROC curve of MA values for predicting platelet decrease was0.8339, which has a high predictive value. Conclusion The maximum blood clot intensity value in thromboelastography of patients with se

关 键 词：最大血块强度值 血栓弹力图 脓血症 血小板计数 疾病转归 

分 类 号：R631[医药卫生—外科学]