脓毒症患者凝血功能的改变及其意义

Changes and Significance of Coagulation Dysfunction of Sepsis Patients

目的研究脓毒症患者凝血功能的变化及其意义。方法按照脓毒症诊断标准，将76例患者分为生存组50例和死亡组26例，一经确诊即抽血检查凝血四项、D-二聚体浓度、血小板及白细胞计数。结果与生存组比较，死亡组的APTT、PT显著延长，D-二聚体浓度、白细胞计数显著增高，纤维蛋白原浓度、血小板计数显著降低（P〈0．05）。结论脓毒症患者存在凝血系统功能紊乱，其中D-二聚体浓度、血小板计数与脓毒症的严重程度有显著相关性，对判断患者的预后及评估病情、严重程度有重要意义。

Objective To study the changes of coagulopathy in sepsis patients,and to look for it＇s clinical significance.Method A total of 76 patients were enrolled in present study.According to the diagnostic criteria for sepsis,these patients were divided into two groups,survival（n=50）and death（n=20）.The venous blood samples were taken from the patients as soon as they entered ICU and following parameters were determined：prothrombin time （PT）,activated partial thromboplastin time （APTT）,fibrinogen （Fib）,intemational normalized ratio （INR）,D-dimer, platelet （PLT）,and white blood cells （WBC）.Results APTT and PT were longer in death group.D-dimer and WBC were higher in death group.Fib and PLT were lower in death group.All the differences were of statistical significance （P〈0.05）.These changes were closely correlated with the APACHE Ⅱ score.Conclusions The coagulation dysfunction is much severe in the traumatic patients with sepsis.The severity of post traumatic sepsis is significantly related only with PLT and D-dimer,which may therefore act as adoptable parameters in the developing system of sepsis score.