脓毒症休克患者凝血功能紊乱与病情严重度及预后的关系

Relationship of blood coagulation disorders with the severity of disease and prognosis in the patients with septic shock

目的探讨脓毒症休克患者凝血功能紊乱与病情严重度及预后的关系。方法2004-12-2007-01收住我院ICU和EICU的脓毒症休克患者,通过测定血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）和血小板计数（PLT）分为凝血功能正常组和凝血功能异常组,追踪其预后情况判断凝血功能障碍与病情严重度的关系及对预后的影响。结果PT异常组、PT和APTT均异常组患者死亡率明显高于其结果正常的对照组（P〈0.05）;而APTT异常组和PLT异常组分别与其结果正常的对照组死亡率比较差异无统计学意义（P〉0.05）。PLT计数下降组和PT异常组APACHEⅡ评分均明显高于PLT正常组和PT正常组（P〈0.05）。结论与凝血功能相关的主要指标PLT、PT、APTT的检测对判断脓毒症休克患者的预后及评估病情严重度有一定指导意义。

Objective To explore the relationship of blood coagulation disorders with the severity of disease and prognosis in patients with septic shock. Methods 59 patients with septic shock admitted to our hospital from December 2004 to January 2007 were divided into several groups according to prothromhin time （PT） , activated partial thromhoplastin time （APTT） , platelet （PLT） count. The relationship of the blood coagulation disorders with the severity of disease and prognosis was analyzed in the patients with septic shock. Result The mortality of abnormal PT group and abnormal group of both PT and APTT was more higher than that of the normal control group （ P 〈 0.05 ） ; while the mortality of abnormal APPT group and abnormal blood platelet count （ BPC ） group was similar to that of the normal control group statistically （ P 〉 0.05 ）. The APACHE Ⅱ score of abnormal PT group and the group with degression of BPC was obviously higher than that of the normal control group （ P 〈 0.05） .Conclusion The detection of the major parameter correlating with cruor function： PLT,PT,APTT is important for the judgement of the prognosis of patients with septic shock and the evaluation of the severity of patient＇s condition.