凝血功能指标与重症监护室老年实体恶性肿瘤患者预后的相关性研究  

A study on correlation between coagulation function indexes and prognosis of elderly ICU patients with solid malignant tumors

作　　者：张海涛 葛仁美 Zhang Haitao;Ge Renmei(Department of Laboratory Medicine,People's Hospital of Hai'an City,Hai'an,Jiangsu,226600,P.R.China)

机构地区：[1]海安市人民医院检验科,江苏海安226600

出　　处：《老年医学与保健》2025年第1期47-52,共6页Geriatrics & Health Care

摘　　要：目的探究凝血功能指标与重症监护室(ICU)老年实体恶性肿瘤患者预后之间相关性。方法纳入2019年1月—2024年10月海安市人民医院ICU收治的101例实体恶性肿瘤老年患者,根据28 d内是否死亡分为存活组(n=69)和死亡组(n=32)。收集并比较2组患者的凝血功能指标凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、国际标准化比值(INR)、纤维蛋白原(Fib)和D-二聚体水平。结果与存活组患者相比,死亡组患者的APACHEⅡ评分、SOFA评分、D-二聚体和纤维蛋白原水平升高(均P<0.05)。PT、APTT和INR与患者的预后结局无显著相关性(均P>0.05)。ROC曲线分析显示,D-二聚体和纤维蛋白原鉴别患者预后的曲线下面积分别为0.84和0.70。多因素二元Logistic回归表明,在校正混杂因素后,D-二聚体(OR=1.65,95%CI:1.09~1.97)和纤维蛋白原(OR=1.46,95%CI:1.08~1.88)水平是患者28 d内死亡的独立危险因素。结论常规凝血功能检测指标值,特别是D-二聚体和纤维蛋白原水平,可能有助于评估ICU老年实体恶性肿瘤患者的28 d预后,具有一定的临床应用价值。Objective To investigate the correlation between the coagulation function indexes and prognosis of elderly patients with solid malignant tumors in intensive care unit(ICU).Methods A total of 101 elderly ICU patients with solid malignant tumors admitted to People's Hospital of Hai'an City from January 2019 to October 2024 were enrolled and divided into survival group(n=69)and non-survival group(n=32)according to whether they died within 28 days.Their coagulation function indexes,including prothrombin time(PT),activated partial thromboplastin time(APTT),international normalized ratio(INR),levels of fibrinogen(Fib)and D-dimer,were measured and compared between the two groups.Results Compared with the survival group,the non-survival group exhibited significantly higher APACHEⅡscore,SOFA score,and levels of D-dimer and Fib(all P<0.05).PT,APTT and INR showed no significant correlation with prognosis of patients(all P>0.05).ROC curve analysis showed that the area under the curve of D-dimer and Fib for predicting the prognosis of patients was 0.84 and 0.70,respectively.Multivariate binary Logistic regression showed that D-dimer(OR=1.65,95%CI:1.09--1.97)and Fib(OR=1.46,95%CI:1.08--1.88)were independent risk factors for death within 28 days after adjusting for confounders.Conclusion Routine coagulation function index values,especially the levels of D-dimer and Fib may be helpful to evaluate the 28-day prognosis of elderly ICU patients with solid malignant tumors,and have certain clinical application value.

关 键 词：老年 凝血 实体恶性肿瘤 重症监护室 预后 D-二聚体 纤维蛋白原 

分 类 号：R47[医药卫生—护理学]