前白蛋白、D-二聚體及血小板動態變化評估重癥膿毒癥患者病情嚴重度的臨床分析_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 楊鈞 ¹ , 奚晶晶 ²

Corresponding?author：

楊鈞, Email: yangj8298@163.com

Keywords：

重癥膿毒癥; 前白蛋白; D-二聚體; 血小板; 急性生理學和慢性健康狀況評分系統Ⅱ

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目的研究前白蛋白( PA) 、D-二聚體( DD) 及Plt 動態變化與重癥膿毒癥患者病情嚴重度及預后的關系。方法測定198 例重癥膿毒癥患者入組第1 d、第5 d, 以及出院或死亡前最后一次的PA、DD、Plt、APACHEⅡ 評分, 按預后將患者分為死亡組及存活組, 進行動態觀察, 并做APACHEⅡ評分和PA、DD 及PLT 水平動態變化的相關性分析。結果死亡組與存活組入組第1 dPA、DD 及Plt 比較均無顯著差異, 死亡組第5 d 及最后一次DD 水平明顯高于存活組( P lt;0. 05) , PA和Plt 明顯低于存活組( P lt;0. 01) 。DD 與APACHEⅡ評分呈正相關, PA、Plt 與APACHEⅡ評分呈負相關。結論 DD與膿毒癥患者病情嚴重程度呈正相關, PA 與病情嚴重程度呈負相關。DD 持續高水平與PA、Plt 持續低水平提示病情危重, 預后不良, 所以聯合動態觀察PA、DD 和Plt 對判斷病情危重度及預后有一定的評估價值。

Citation： 楊鈞,奚晶晶. 前白蛋白、D-二聚體及血小板動態變化評估重癥膿毒癥患者病情嚴重度的臨床分析. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(3): 292-293. doi: Copy

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1. Dellinger RP, Carlet JM, Masur H, et al. Surviving Sepsis Campaign guideline for treatment of severe sepsis and septic shock. Crit Care Med, 2004, 32, 3: 858-873.
2. Stoica GS, Cohen RI, Rossoff LJ. Adult Still’s disease and respiratory failure in a 74 year old woman. Postgrad Med J, 2002, 78: 97-98.
3. Pinilla JC, Hayes P, Laverty W, et al. The C-reactive protein to prealbumin ratio correlates with the severity of multiple organ dysfunction. Surgery, 1998, 124: 799-805.
4. ten Cate H, Timmerman JJ, Levi M. The pathophysiology of disseminated intravascular coagulation. Thromb Haemost, 1999, 82 :713-717.
5. Brun-Buisson C, Doyon F, Carlet J, et al. Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA, 1995, 274: 968-974.
6. 華川. 應激狀態下影響血小板聚集功能的相關因素. 華北國防醫藥, 2006, 18: 279 -281.
7. Gando S, Nanzaki S, Sasaki S, et al. Activation of t he ex2 t rinsic coagulation pat hway in patient s with severe sepsis and septic shock.Crit Care Med, 1998, 12: 2005-2009.

Chinese Journal of Respiratory and Critical Care Medicine

前白蛋白、D-二聚體及血小板動態變化評估重癥膿毒癥患者病情嚴重度的臨床分析

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