恶性肿瘤合并脓毒症患者血小板相关参数的临床意义  

Clinical significance of platelet-related parameters in patients with malignant tumor complicated with sepsis

作　　者：段玉波 徐平平 刘鹏 涂小丽 邱宇安[1] DUAN Yubo;XU Pingping;LIU Peng;TU Xiaoi;QIU Yuan(Department of Intensive Care Medicine,Jiangxi Cancer Hospital,Nanchang,Jiangxi,330029,China)

机构地区：[1]江西省肿瘤医院重症医学科,江西南昌330029

出　　处：《当代医学》2023年第28期15-19,共5页Contemporary Medicine

基　　金：江西省卫健委普通科技计划(202130729)。

摘　　要：目的探究恶性肿瘤合并脓毒症患者血小板(PLT)相关参数的临床意义。方法选取2019年3月至2022年3月江西省肿瘤医院收治的80例恶性肿瘤合并脓毒症患者作为研究对象,按PLT计数诊断标准分为轻度PLT减少组、中度PLT减少组、重度PLT减少组与非PLT减少组,每组20例。检测所有患者PLT、PLT平均体积(MPV)、PLT分布宽度(PDW)、大PLT比率(P-LCR),比较4组临床资料及PLT、MPV、PDW、P-LCR,采用Pearson相关分析PLT、MPV、PDW、P-LCR与急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的相关性,绘制ROC曲线分析PLT相关参数表达对恶性肿瘤合并脓毒症患者的诊断价值。结果4组感染性休克发生率、APACHEⅡ评分、病死率、体温、呼吸、心率、HCO3-、空腹血糖(FBG)比较差异有统计学意义(P<0.05)。非PLT减少组、轻度PLT减少组、中度PLT减少组、重度PLT减少组PLT水平呈降低趋势,MPV、PDW、P-LCR水平呈升高趋势,差异有统计学意义(P<0.05)。PLT与APACHEⅡ评分呈负相关(r<0,P<0.05),MPV、PDW、P-LCR与APACHEⅡ评分均呈正相关(r>0,P<0.05)。ROC曲线分析结果显示,PLT、MPV、PDW、P-LCR联合诊断恶性肿瘤合并脓毒症的灵敏度、准确度、AUC均高于PLT、MPV、PDW、P-LCR单项诊断。结论PLT参数可作为评估恶性肿瘤合并脓毒症病情发展状态的早期预警性指标,PLT相关参数的变化可间接反映骨髓代偿增生情况,对PLT、MPV、PDW、P-LCR等指标实施动态监测对PLT功能的恢复存在一定预示作用。Objective To explore the clinical significance of platelet(PLT)-related parameters in patients with malignant tumor complicated with sepsis.Methods 80 patients with malignant tumor complicated with sepsis admitted to Jiangxi Cancer Hospital from March 2019 to March 2022were selected as the research subjects,they were divided into the mild thrombocytopenia group,the moderate thrombocytopenia group,the se-vere thrombocytopenia group and the non-thrombocytopenia group according to the diagnostic criteria of PLT count,with 20 cases in each group.Platelet(PLT),mean PLT volume(MPV),PLT distribution width(PDW)and PLT large cell ratio(P-LCR)were detected,the clinical data and PLT,MPV,PDW,P-LCR were compared among the four groups,Pearson correlation analysis was used to analyze the correlation between PLT,MPV,PDW,P-LCR and acute physiology and chronic health evaluation scoring systemⅡ(APACHEⅡ)score,ROC curve was drawn to analyze the di-agnostic value of PLT-related parameter in patients with malignant tumor complicated with sepsis.Results There were significant differences in the incidence of septic shock,APACHEⅡscore,mortality,body temperature,respiration,heart rate,HCO3-and fasting blood glucose(FBG)among the four groups(P<0.05).The levels of PLT in the non-thrombocytopenia group,the mild thrombocytopenia group,the moderate thrombocytopenia group and the severe thrombocytopenia group showed decreasing trend,while the levels of MPV,PDW and P-LCR showed an increasing trend,and the differences were statistically significant(P<0.05).PLT was negatively correlated with APACHEⅡscore(r<0,P<0.05),MPV,PDW and P-LCR were positively correlated with APACHEⅡscore(r>0,P<0.05).ROC curve analysis showed that the sensitivity,accuracy and AUC of PLT,MPV,PDW and P-LCR combined diagnosis of malignant tumor complicated with sepsis were higher than those of PLT,MPV,PDW and P-LCR single diagnosis.Conclusion PLT parameters can be used as an early warning index to evaluate the development status of malignant tumors with sepsis,the chan

关 键 词：恶性肿瘤合并脓毒症 血小板 血小板分布宽度 血小板平均体积 大血小板比率 

分 类 号：R459.7[医药卫生—急诊医学] R73[医药卫生—治疗学]