前白蛋白、D-二聚体及血小板动态变化评估重症脓毒症患者病情严重度的临床分析_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 杨钧 ¹ , 奚晶晶 ²

Corresponding author：

杨钧, Email: yangj8298@163.com

Keywords：

重症脓毒症; 前白蛋白; D-二聚体; 血小板; 急性生理学和慢性健康状况评分系统Ⅱ

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目的研究前白蛋白( PA) 、D-二聚体( DD) 及Plt 动态变化与重症脓毒症患者病情严重度及预后的关系。方法测定198 例重症脓毒症患者入组第1 d、第5 d, 以及出院或死亡前最后一次的PA、DD、Plt、APACHEⅡ 评分, 按预后将患者分为死亡组及存活组, 进行动态观察, 并做APACHEⅡ评分和PA、DD 及PLT 水平动态变化的相关性分析。结果死亡组与存活组入组第1 dPA、DD 及Plt 比较均无显著差异, 死亡组第5 d 及最后一次DD 水平明显高于存活组( P lt;0. 05) , PA和Plt 明显低于存活组( P lt;0. 01) 。DD 与APACHEⅡ评分呈正相关, PA、Plt 与APACHEⅡ评分呈负相关。结论 DD与脓毒症患者病情严重程度呈正相关, PA 与病情严重程度呈负相关。DD 持续高水平与PA、Plt 持续低水平提示病情危重, 预后不良, 所以联合动态观察PA、DD 和Plt 对判断病情危重度及预后有一定的评估价值。

Citation： 杨钧,奚晶晶. 前白蛋白、D-二聚体及血小板动态变化评估重症脓毒症患者病情严重度的临床分析. 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. 华川. 应激状态下影响血小板聚集功能的相关因素. 华北国防医药, 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-二聚体及血小板动态变化评估重症脓毒症患者病情严重度的临床分析

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