血小板变异率对危重病患者的预后评价.docVIP

血小板变异率对危重病 患者的预后评价 谌宏军1 刘丽丽2 张伟1 陈淼1 黄英1 傅小云1 罗朝勇3 （1. 遵义医学院附属医院重症医学科；2.遵义医学院附属医院脑血管外科；3.仁怀市人民医院急诊科 遵义563003） [摘要] 目的 探讨血小板变异率对危重病患者预后判断的价值。方法 将入住重症医学科的危重病患者按血小板计数低于50×109/L纳入研究，排除肝素诱导、免疫疾病、脾切除术后、使用抗血小板药物及化疗药物所致的血小板减少病例，按随访结果再分为存活组和死亡组，记录符合要求的患者入ICU24h、3、5、7d的血小板计数，并计算其变异率及生存与危险函数。结果 共29例病例纳入研究，入住ICU当日血小板计数低于50×109/L占2.8%，观察期间死亡4人，占13.79%。各时段血小板平均值比较，入住重症医学科当日、第三日、第五日均数值两两相比，t=-3.225，-4.664，-3.613，P=0.002，0.001，0.001，差异有统计学意义。第七日与第五天相比，t=-2.789，P=0.8，差异无统计学意义。?2=-2.4815，4.045，P=0.017，0.006，差异有统计学意义，第三日与入院当日，?2=1.5635，P=0.442，第七日与第五日相比，?2=3.571，P=0.620，差异无统计学意义。Platelet variation rate for evaluating prognosis in critically ill patients (Chen Hong-jun1, Liu Li-Li2, Zhang Wei1, Chen Miao1, Huang Ying1, Fu Xiao-Yun1, Luo Chao-Yong3. 1. Department of critical care medicine, Affiliated hospital of Zunyi medical college, 2.Department of cerebral vascular, Affiliated hospital of Zunyi medical college, 3.Department of emergency, the people’s hospital of Renhuai Zunyi 563003 China) ABSTACTS [Objective] To evaluate the value of the platelet variation rate in critically ill patients. [methods] We performed a case in which 29 patients who developed severe thrombocytopenia of less than 50?09/L owere carefully matched for the severity of underlying disease. According to the results of follow-up is further divided into live group and death group. To meet the conditions of the inpatient admissions of ICU24h, 3, 5, 7d platelet count, and calculated the platelet variation rate and survival function and hazard function, excepting heparin induced, immune disease, splenectomy, the use of antiplatelet agents and chemotherapy drugs of these cases. [results] A total of 29 patients were included; 2.8% presented with severe thrombocytopenia during the first day of admission. A total of 13.79% died during admission in the ICU. According to the platelet count mean comparison analysis, the difference was statistically significant in the inpatient admission, on the 3rd、5th day (t = 3.225, 4.664,