重症肺炎患者P-选择素与血小板参数变化的临床研究

Clinical Research of P-Selectin Level and Platelet Parameter Changes in Patients with Severe Pneumonia

目的观察重症肺炎患者P-选择素(P-Selectin)和血小板参数的变化,探讨其在重症肺炎患者病情评估及预后判断中的意义。方法测定48例重症肺炎患者(A组)的P-选择素、血小板参数包括血小板(PLT)计数、血小板分布宽度(PDW)、平均血小板容积(MPV)及大血小板比例(P-LCR),同时与普通肺炎患者60例(B组)和健康体检者50名(C组)进行比较。结果入院24h内A组P-选择素、PLT明显高于B组、C组,差异均有统计学意义(P<0.01),而PDM、MPV、P-LCR低于B组、C组,差异有统计学意义(P<0.01);B组PLT高于C组,差异有统计学意义(P<0.01),而P-选择素、PDW、MPV、P-LCR与C组比较差异无统计学意义(P>0.05)。发生MODS者与未发生MODS者、存活组与死亡组比较,其PLT均显著降低,差异有统计学意义(P<0.01),而P-选择素、MPV、PDW及P-LCR水平均显著增高,差异有统计学意义(P<0.05)。结论检测重症肺炎患者的P-选择素、血小板参数可能有助于评估其疾病程度及预后。

Objective To investigate the changes of P -Selectin Level and Platelet Parameters in patients with severe pneumonia and evaluate the significance of them in patient＇s condition and prognosis of severe pneumonia. Methods The level of P - Selectin, and platelet parameters including platelet count （ PLT）, platelet distribution width （ PDW）, mean platelet volume （MPV） and platclet-large cell ratio （P- LCR） were detected in 48 patients with severe pneumonia （group A） , 60 with general pneumonia （ group B） and 50 healthy controls （ group C）. The results were compared. Results The levels of P - Selectin and PLT in the group A were significantly higher than those in the group B and group C （P 〈0. 01 ） , while the levels of PDW, MPV and P - LCR were significantly lower than those in the group C in 24 hours （ P 〈 O. 01 ）. The level of PLT in the group B was significantly higher than that in the group C （P 〈0. 01 ）, but the levels of PDW, MPV, P- LCR were not significantly different from those in the group C （ P 〉 0. 05 ）. The level of PLT in the patients with multiple organ dysfunction syndrome （MODS） and survived was significantly lower than that in the patients with no MODS and died （P 〈0. 01 ）, but the levels of P - Seleetin, MPV, and PDW were significantly higher （ P 〈 0. 05 ）. Conclusion The detection of P - Selectin Level and platelet parameters may be helpful in evaluating the severity and prognosis of disease in patients with severe pneumonia.