SIRS病人凝血障碍的动态变化

Dynamic change of blood coagulation in SIRS patients

目的 探讨系统性炎症反应综合征 (systemicinflammatoryresponsesyndrome ,SIRS)病人凝血功能障碍与病情严重程度和预后的关系。方法 6 4例SIRS病人按APACHEⅡ评分分为轻型组、重型组、死亡组 ,发病 0 ,2 ,4 ,6d分别检测抗凝血酶Ⅲ (AT Ⅲ )、组织型纤溶酶原激活物 (t PA)、组织型纤溶酶原激活物抑制剂 (PAI)、血小板α 粒膜蛋白质 (GMP 14 0 ) ,P选择素 ,P selection)。结果 SIRS病人凝血和纤溶系统被激活 ,并伴有纤溶受抑 ,死亡者与存活者差异有显著性 (P <0 .0 1) ,并与疾病严重程度和预后有一定的相关性。结论 动态监测SIRS患者止凝血指标有助病情的判断和预后的估计。

Objective To investigate the blood coagulation disorder in SIRS patients. Methods Sixty-four patients were divided into mild,severe and dead groups. All patients’AT-Ⅲ,t-PA,PAI,GMP-140 and P-selection were measured on 0,2,4 and 6 days after admission. Results The coagulation and fibrinolysis were activated,and fibrionolysis was inhibited. There was a significant difference between survivors and dead group(P<0.01).These changes were closely correlated with the APACHE-Ⅱ score. Conclusion Change in coagulation parameters is important for evaluating the condition and prognosis of SIRS patients.