凝血功能紊乱及危重症患者病情及预后相关性探究.docVIP

凝血功能紊乱及危重症患者病情及预后相关性探究[摘要] 目的：探讨危重症患者凝血功能的改变与病情严重程度和预后的关系。方法：将68例危重症患者按急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ）评分分为A（25分）三组，D组为健康对照组，分析不同评分患者血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）和血小板（PLT）的水平变化与APACHEⅡ的关系。并根据患者预后分为存活组和死亡组，比较两组上述指标的差异。结果：危重症患者APTT、PT、TT明显长于D组，PLT和FIB明显低于D组，差异有统计学意义（P0.05），TT、PLT和FIB与D组比较差异无统计学意义（P0.05）。结论：危重症患者普遍存在凝血系统功能紊乱，PT、APTT、TT、FIB和PLT对患者的预后及病情轻重的判断具有重要价值 [关键词] 危重症；凝血酶原时间；活化部分凝血活酶时间；凝血酶时间；纤维蛋白原；血小板 [中图分类号] R554 [文献标识码] Ａ [文章编号] 1673-7210（2011）12（a）-057-03 Correlation study between coagulation disorders and severity and prognosis with critically ill patients CUI Yanli, YU Yang, LIU Hongbin, HE Lizhen Department of Laboratory, the Second People’s Hospital of Jiaozuo City, He′nan Province, Jiaozuo 454100, China [Abstract] Objective: To explore the relationship between coagulation disorders and severity and prognosis with critically ill patients. Methods: 68 critically ill patients were divided into three groups based on acute physiology and chronic Health Evaluation(APACHE)Ⅱ, that were A group (APACHE score25)，group D (normal control group). The prothrombin time (PT)，activated partial thromboplastin time (APTT)，thrombin time (TT)，fibrinogen (FIB)，platelet (PLT) were measured, and the relationship between the coagulation markers and APACHEⅡscore were studied by statistical analysis. Patients were divided into two groups according to survival or death according to prognosis. Results: Compared with the normal control group, APTT, PT, TT in patient group were significantly prolonged (all P0.05). APTT, PT, TT were significantly prolonged and PLT, FIB were significantly lower in nonsurvivor than those of survivor. Conclusion: The coagulation disorders with critically ill patients is universal existence, and the measurement of PT, APTT, TT, FIB, PLT can reflect critical patients’ ill condition and predict their prognosis. [Key words] Critical illness；Prothrombin time；Activated partial thromboplastin time；Thrombin time；Fibrinogen；Platele