脓毒症患者凝血系统功能紊乱的研究

Study of Coagulation Dysfunctions in The Patients with Sepsis

目的:探讨脓毒症患者凝血功能紊乱与病情严重程度及预后的关系。方法:将2005年6月至2006年12月入住我院重症监护病房的脓毒症患者分为生存组30例,死亡组16例,分别检测血小板计数(PLT)、D-二聚体(DD)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FBG),分析比较两组患者的差异及主要凝血指标与病情严重度(APACHEII评分)的关系。结果:脓毒症患者死亡组与生存组比较血小板计数减少(P<0.05)、活化部分凝血活酶时间延长(P<0.01)、D-二聚体升高(P<0.01)、纤维蛋白原降低(P<0.01),PLT、APTT、DD与APACHEII评分有相关性。结论:脓毒症时存在凝血功能紊乱,动态监测其凝血指标对判断患者的预后及评估病情严重程度有重要意义。

Objective： To investigate the relationship between coagulation disorders and severity and prognosis in sepsis. Methods： All the patients were divided into 2 groups：survival（n=30） and death（n=16）. Levels of platelet count （PLT）,D-dimer（DD）,prothrombin time （PT）,thrombin time （TT）,activated partial thromboplastin time （APTT） and fibrinogen （FBG） were measured in all patients at the admission day. The differences of coagulation markers between the two groups were analyzed and the relationship between the coagulation markers and APACHE Ⅱ score were studied. Results： Platelet count was decreased（P 〈 0.05）,so was FBG（P 〈 0.01） and DD elevated obviously in death groups, APTT was prolonged in the death group, these changes were closely correlated with the APACHE Ⅱ score. Conclusions： The are the dysfunctions of coagulation in the patients with sepsis, PIT, APTT, DD is associated with the prognosis and severity of sepsis.