血小板、血乳酸、剩余碱水平与脓毒症患者炎症反应及预后的关系分析  

Relationship between PLT,LAC,BE Levels and Inflammatory Factors and Prognosis of Sepsis Patients

作　　者：方良好 周敏 刘秋江[1] FANG Liang-hao;LIU Qiu-jiang;ZHOU Min(Guangdong Second Traditional Chinese Medicine Hospital,Guangdong Guangzhou,510030)

机构地区：[1]广东省第二中医院重症医学科,510030

出　　处：《岭南急诊医学杂志》2024年第5期470-472,476,共4页Lingnan Journal of Emergency Medicine

基　　金：广东省医学科学技术研究基金项目(B2021372)。

摘　　要：目的:探讨血小板、血乳酸、剩余碱水平与脓毒症患者机体炎症反应和预后的关系。方法:回顾性分析广东省第二中医院重症医学科2022年1月~2023年9月收治的100例脓毒症患者临床资料,按28 d死亡情况分为存活组(n=68)和死亡组(n=32),分析患者血小板、血乳酸、剩余碱水平与炎症指标(降钙素原、C反应蛋白、白介素66)的相关性,并分析其与脓毒症患者预后的关系。结果:血小板与降钙素原、白介素6呈负相关,与白细胞水平呈正相关,相关系数分别为-0.327、-0.278和0.279;血乳酸与降钙素原、白介素6、C反应蛋白、APACHEII评分和预期死亡率均呈正相关,相关系数分别为0.400、0.615、0.328、0.270和0.238;剩余碱与降钙素原、白介素6、C反应蛋白、APACHEII评分和预期死亡率均负正相关,相关系数分别为-0.497、-0.477、-0.390、-0.213和-0.257,以上相关性均有统计学意义(P值小于0.05)。多因素COX回归分析显示,与血小板水平减少组相比,血小板在正常范围内(100~300*10^9/L)的患者28天内死亡风险较低。结论:脓毒症患者血小板、血乳酸、剩余碱水平与机体炎症反应密切相关,维持血小板水平在正常值范围内,有助于改善患者预后。Objective:To analyse the relationship between the levels of PLT,LAC,BE and the inflammatory factors and prognosis of patients with sepsis.Methods:Clinical data of 100 patients with sepsis admitted to the Department of Intensive Care Medicine of the Second Hospital of Traditional Chinese Medicine of Guangdong Province from January 2022 to September 2023 were retrospectively analyzed,and they were divided into survival group(n=68)and death group(n=32)according to the death status of 28 days.The correlation between PLT,LAC,BE levels and inflammatory indicators(PCT,CRT,IL-6),and the relationship with the prognosis of sepsis patients were analyzed.Results:PLT were negatively correlated with PCT and IL-6,and positively correlated with WBC levels,the correlation coefficients were-0.327,-0.278 and 0.279,respectively.LAC was positively correlated with PCT,IL-6,CRT,APACHEII score and expected mortality,and the correlation coefficients were 0.400,0.615,0.328,0.270 and 0.238,respectively.BE was negatively correlated with PCT,IL-6,CRT,APACHEII score and expected mortality,and the correlation coefficients were-0.497,-0.477,-0.390,-0.213 and-0.257,respectively.All of the correlations were statistical significant(P<0.05).Multivariate COX regression analysis showed that patients with platelets in the normal range group(100 to 300*10^9/L)had a lower risk of death within 28 days compared to the group with reduced platelet levels.Conclusion:The levels of PLT,LAC and BE in sepsis patients are closely related to the inflammatory response of the body.Maintaining PLT levels in the normal range is helpful to improve the prognosis of patients.

关 键 词：血小板 血乳酸 剩余碱 脓毒症 炎症反应 预后 

分 类 号：R459.7[医药卫生—急诊医学]