摘要
目的分析血小板聚集率对脓毒症相关凝血功能障碍的诊断和预后价值。方法选择2021年6月至2024年6月新疆维吾尔自治区人民医院238例脓毒症患者,根据是否发生脓毒症相关凝血功能障碍分为障碍组(n=142)与非障碍组(n=96),对比2组一般资料、血小板聚集率及凝血功能相关指标。随访28 d预后生存情况,对比血小板聚集率。分析脓毒症相关凝血功能障碍发生的影响因素,ROC曲线分析血小板聚集率对脓毒症相关凝血功能障碍预后的预测价值。结果障碍组APACHEⅡ评分、降钙素原(procalcitonin,PCT)、活化部分凝血酶时间(activated partial thromboplastin time,APTT)、血小板聚集率、SOFA评分高于非障碍组,纤维蛋白原(fibrinogen,Fib)低于非障碍组(P<0.05),分别为:(18.30±2.00)分vs.(10.76±1.42)分,(7.27±2.10)ng/mL vs.(3.87±1.62)ng/mL,(46.78±3.22)s vs.(40.43±0.90)s,(69.07±6.32)%vs.(55.78±2.96)%,(7.91±2.21)分vs.(4.72±1.76)分,(243.23±40.91)mg/dL vs.(342.09±46.58)mg/dL;APTT、PCT水平上升和血小板聚集率上升、APACHEⅡ评分和SOFA评分上升均是脓毒症相关凝血功能障碍发生的危险因素(OR>1,P<0.05);死亡组血小板聚集率(%)比存活组高,(74.10±5.19)vs.(66.05±4.87)(P<0.05);血小板聚集率和PCT联合预测的AUC最高,显著优于单一指标(血小板聚集率:AUC=0.868;PCT:AUC=0.854,P<0.05)。结论血小板聚集率是脓毒症相关凝血功能障碍发生的独立危险因素,也可有效预测脓毒症凝血功能障碍患者预后。
Objective To analyze the diagnostic and prognostic value of platelet aggregation rate in sepsis-related coagulation disorders.Methods A total of 238 patients with sepsis were enrolled from Xinjiang Uygur Autonomous Region People′s Hospital between June 2021 to June 2024.Patients were divided into coagulation dysfunction group(n=142)and non-dysfunction group(n=96)based on the occurrence of sepsis-related coagulation dysfunction.The general data,platelet aggregation rate and coagulation-related indicators of the two groups were compared.The 28-day survival outcomes were evaluated,and platelet aggregation rates were compared between survivors and non-survivor groups.Factors influencing the occurrence of sepsis-related coagulation dysfunction were analyzed.ROC curves were used to evaluate the predictive value of platelet aggregation rate for the prognosis of sepsis-related coagulation dysfunction.Results Compared to the non-dysfunction group,APACHE II score,procalcitonin(PCT),activated partial thromboplastin time(APTT),platelet aggregation rate,and SOFA score were higher in the dysfunction group,while fibrinogen(Fib)was lower in the dysfunction group(P<0.05).The values were:(18.30±2.00)points vs(10.76±1.42)points,(7.27±2.10)ng/mL vs(3.87±1.62)ng/mL,(46.78±3.22)s vs(40.43±0.90)s,(69.07±6.32)%vs(55.78±2.96)%,(7.91±2.21)points vs(4.72±1.76)points,(243.23±40.91)mg/dL vs(342.09±46.58)mg/dL,respectively.The APTT、PCT level,platelet aggregation rate,APACHE II score and SOFA score were all risk factors for the development of sepsis-related coagulation dysfunction(OR>1,P<0.05).The platelet aggregation rate was higher in the non-survivor group compared to the survivor group(74.10±5.19 vs 66.05±4.87,P<0.05).The combination of platelet aggregation rate and PCT yielded the highest AUC for prediction,which was significantly greater than that of either single indicator(platelet aggregation rate:AUC=0.868;PCT:AUC=0.854,P<0.05).Conclusion Platelet aggregation rate is an independent risk factor for the development of sepsis-associated coagulation dysfunction,and also an effective predictor for the prognosis of patients with sepsis coagulation dysfunction.
作者
王儒彬
马筱洁
李菲
陈伟
WANG Rubin;MA Xiaojie;LI Fei;CHEN Wei(Department of Blood Transfusion,People′s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000,China)
出处
《中国输血杂志》
2025年第11期1542-1547,共6页
Chinese Journal of Blood Transfusion
基金
新疆维吾尔自治区自然科学基金面上项目(2023D01C73)
新疆维吾尔自治区自然科学基金青年科学基金(2022D01C807)
新疆维吾尔自治区“天山英才”医药卫生高层次人才项目(TSYC202401B157)
新疆维吾尔自治区自然科学基金面上项目(2022D01C637)
新疆维吾尔自治区人民医院院内项目(20190409)
新疆维吾尔自治区人民医院院内项目(20230239)。
关键词
脓毒症
相关凝血功能障碍
血小板聚集率
诊断
预后
sepsis
sepsis-associated coagulation dysfunction
platelet aggregation rate
diagnosis
prognosis
