危重病人血小板水平与预后的研究

Platelet level in predicting the prognosis of the critical illness

目的探讨血小板水平在预测危重病人预后中的意义。方法收入ICU的危重病患者84例,入选标准为各种原因所致的SIRS并除外DIC。将病例分为死亡组(n=23)和存活组(n=61)。入院当天及第7、14天检查血小板和进行APACHEⅡ评分。分析两组病人的血小板水平、APACHEⅡ评分的情况。结果入住ICU时存活组和死亡组患者的血小板水平均降低,治疗7天和14天后存活组血小板计数上升至正常范围,而死亡组血小板进行性下降(P<0.01)。入住ICU时两组APACHEⅡ评分均明显升高,无显著性差异,治疗7天和14天后存活组APACHEⅡ评分下降至10分以下,而死亡组上升至20分以上,两组有显著性差异(P<0.01)。结论血小板水平能比较准确、敏感地反映危重病患者的病情和预后。而且血小板检查快速、简单易行、价廉,在临床上有很大的实用价值。

Objective To investigate the significance of the levels of platelet in predicting the prognosis of the critical illness. Methods In ICU 84 crtically ill patients who suffered from SIRS were, enrolled in this study and divided into two groups, dead group（n=23） and alive group（n=61）. Platelet count and APACHE Ⅱ scores were performed immediately after hospitalization and 7,14 days later. Analysis of the relationship between the levels of platelet and APACHE Ⅱ Results Platelet was lower in both groups immediately after hospitalization. After 7 days and 14 days therapy, it increased to the normal rang in the alive group. However, it progressively dropped in the dead group（P〈0.001）. APACHE II scores was much higher, but no difference in the two groups immediately after hospitalization. After 7 days and 14 days therapy, it decreased dramatically in the alive group, and increased markedly in the dead group. There was a significant difference between the two groups（p〈0.001）. Conclusions Refractory thromboeytopenia is sensitively responsive to poor prognosis and severity of critically ill patients. Key words