血小板计数及动态变化在瓣膜置换术后SIRS中的意义

Significance of platelet counts and dynamic changes in patients after cardiac valve replacement

目的 监测心脏瓣膜置换术后血小板计数的动态变化 ,探讨血小板计数与病情及预后的关系。方法 87例心脏瓣膜置换术患者 ,从术后 6h开始动态监测血小板值的变化 ,根据有无全身炎症反应综合征 (SIRS)分成非SIRS组及SIRS组 ,观察术后恢复情况与血小板下降程度、回升趋势的关系。结果 非SIRS组手术结束 6h血小板计数为术前的 (72± 2 1) % ,术后第 3天开始回升 ,术后第 7天开始超过术前水平。SIRS组手术结束 6h血小板计数为术前的 (4 8± 16 ) % ,恢复到术前水平约需 9～ 17d。两组相比有统计学差异 (P <0 0 5 )。结论 心脏瓣膜置换术后血小板值下降程度与变化趋势能较正确、敏感地反映病情和预后 ,可作为术后能否获得良好恢复的预警指标。

Objective To explore the relationship between dynamic changes of the platelet counts and prognosis after cardiac valve replacement.Methods 87 patients were divided into two groups:systemic inflammatory response syndrome (SIRS) group (n=16) and non-SIRS group (n=71),In this analysis,the dynamic changes of platelet counts were monitored from the day of operation to the seventh day after operation.Results In non-SIRS group,the ratio of the number of platelet counts in 6 hours after operation to preoperation was (72±21)%. This number began to rise from the third day after operation,and on the seventh day,it would exceed the number of preoperation.But in SIRS group,the ratio of the number of platelet counts in 6 hours after operation to preoperation was only 048±016.This number also began to rise from the third day after operation,but its speed was apparently slow ,and on the seventh day,it was only (67±31)% of the number of preoperation.It would spend 9～17 days rising to the number of preoperation.The number of platelet counts in two groups in every point from the sixth hour to the seventh day after operation had statistical difference (P<005).Conclusion The number of platelet counts and its dynamic changes can reflect the patients prognosis after cardiac valve replacement.